A common but often neglected source of emboli

Initial investigations revealed an increased white cell count, coagulopathy, and deranged liver and renal function, with severe mixed respiratory and lactic acidosis. Transoesophageal echocardiography confirmed that the lead entered the left heart through a patent foramen ovale. Unusual course of the ventricular lead crossing the patent foramen ovale.The diffusely dilated bowel loops were due to ischaemic bowel secondary to cardiac embolisation Figure 2.