Medical image of the week: pulmonary thromboembolism complicated by free floating atrial thrombus (original) (raw)
Related papers
International Journal of Cardiology, 2008
A 78-year-old man was admitted with sudden onset of dyspnea followed by syncope. Contrast-enhanced computed tomography showed embolism in the right main pulmonary artery and left upper pulmonary artery. Echocardiography revealed a large, free-floating thrombus and cine magnetic resonance imaging showed highly mobile, low-signal intensity mass in the right atrium, which protruded into the right ventricle during diastole. During surgery the thrombus migrated into the pulmonary artery trunk, but it was successfully removed.
Free-Floating Thrombi in the Right Atrium Causing Pulmonary Embolism
European Journal of Case Reports in Internal Medicine, 2014
A 74--year--old man presented to our Emergency Department with acute dyspnoea. His electrocardiogram showed atrial flutter with 2:1 block and a rate of 150 bpm. Initial investigations revealed a D--dimer level of 6.01 mg/dl. Based on the patient's complaints and the high D--dimer level, computed tomography pulmonary angiography was immediately performed. This showed no evidence of pulmonary embolism, but there were pneumatic changes in the right upper lung lobe. Antibiotics treatment was started with pipracillin/tazobactam, after which the patient's condition improved.
Floating right heart thrombus and massive pulmonary embolism
The Egyptian Journal of Internal Medicine, 2012
Right heart thrombi are a severe form of venous thromboembolic disease and justify diagnosis and treatment in emergency. Free-floating right heart thrombi are a rare phenomenon, generally diagnosed when echocardiography is performed in patients with suspected or proven pulmonary embolism, and have a dismal prognosis if not diagnosed and treated in a timely manner. In our case which presented and treated in December 2010, thrombolytic therapy was the treatment of choice, although other treatment options are available, including anticoagulation and embolectomy.
Acute pulmonary thromboembolism with a floating right-heart thrombus. 4 surgical cases
The Japanese journal of thoracic and cardiovascular surgery : official publication of the Japanese Association for Thoracic Surgery = Nihon Kyōbu Geka Gakkai zasshi, 2001
We determined the efficacy of surgery for acute pulmonary thromboembolism with a floating right-heart thrombus. Thrombi were diagnosed by transthoracic echocardiography and electron beam computed tomography in 4 patients with acute pulmonary thromboembolism with a floating right-heart thrombus, and thromboembolectomy was done in all patients. Surgical procedure included intermittent deep hypothermic circulatory arrest. One patient died of endobronchial hemorrhage and 3 survived. Because acute pulmonary thromboembolism with a right-heart thrombus is life-threatening, immediate thromboembolectomy is required to decrease mortality.
Imminent Pulmonary Embolism: A Fatal Mobile Right Atrial Thrombus
The International Journal of Cardiovascular Imaging, 2006
Right sided heart thrombi are infrequent and if they are mobile they may cause serious morbidity and mortality due to massive pulmonary embolism or paradoxical embolism. Malignancies are one of the important etiological factors for right heart thrombi. A patient with operated but recurrent ovarian carcinoma, presented with symptoms of heart failure was admitted to oncology department. Rapidly progressing dyspnea and a pre-syncope attack required consultation of a cardiologist and echocardiography revealed a mobile thrombus in the right atrium. Urgent open heart surgery was decided but imminent massive pulmonary embolism complicated the case leading to irreversible cardiogenic shock. By means of the presented case this paper overviews etiological factors and treatment options for right sided heart thrombi.
2018
The association between atrial fibrillation and left atrial thrombus had been widely described; on the contrary, the relation between atrial fibrillation and right atrial thrombus hasn’t been demonstrated. We always thought that right atrial thrombus originated from deep venous thrombosis and named as “emboli in transit”. We report the case of a 91 year-old male patient, presenting with a permanent atrial fibrillation, his echocardiography showed a huge floating right atrial thrombus complicated with a bilateral pulmonary embolism. Our aim is to demonstrate through this case the association between atrial fibrillation and right atrial thrombus, using our findings in the literature, and comparing between the prevalence of right and left atrial thrombi in association with atrial fibrillation, explaining the difference between the both, and discussing therapeutic options. © 2018 Elixir All rights reserved. Elixir Physio. & Anatomy 118 (2018) 50628-50630 Physiology and Anatomy Available...
Case Reports in Cardiology, 2015
Free floating right heart thrombus is a rare phenomenon in the context of acute pulmonary embolism and it is associated with a poor outcome. The increased use of echocardiography has led to an increased detection of right heart thrombi. However, optimal management of free floating right heart thrombus remains controversial with no clear consensus. We present the case of a 74-year-old woman who presented to the emergency department with acute onset dyspnea on minimal exertion which had developed over a period of 1 day. A computed tomography of the chest demonstrated massive bilateral proximal pulmonary embolism. A bedside transthoracic echocardiography performed showed a moderately dilated, poorly functioning right ventricle with visible highly mobile serpiginous thrombus moving to and fro across the tricuspid valve. Thrombolytic therapy was immediately initiated with tenecteplase which resulted in excellent results. Although there is no clear consensus for the management of right he...
Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir
Free-floating right heart thrombus is a relatively rare phenomenon and can be seen in 4% to 18% of patients presenting with acute pulmonary embolism. It is mainly diagnosed by transthoracic echocardiography. Echocardiographic examination provides rapid diagnosis and has an important prognostic value because of the high risk for severe pulmonary embolism whose mortality rate exceeds 40%. We present a case of massive pulmonary embolism caused by the rapid migration of a giant, free-floating thrombus from the inferior vena cava to the right heart chambers.