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Right Heart Transvalvular Embolus with High Risk Pulmonary Embolism in a Recently Hospitalized Patient: A Case Report of a Therapeutic Challenge
Joint Authors
Acharya, Gyanendra Kumar
Adedayo, Ajibola Monsur
Prabhu, Hejmadi
Brinster, Derek R.
Mir, Parvez
Source
Issue
Vol. 2015, Issue 2015 (31 Dec. 2015), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2015-08-31
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
Thrombus-in-transit is not uncommon in pulmonary embolism but Right Heart Transvalvular Embolus (RHTVE) complicating this is rare.
A 54-year-old obese male with recent hospitalization presented with severe dyspnea and collapse.
Initial investigations revealed elevated d-dimer and troponin.
CTA showed saddle pulmonary embolus and bedside echocardiogram revealed right ventricular (RV) pressure overload and dilatation (RV > 41 mm), McConnell’s sign, and mobile echodensity attached to tricuspid valve.
Patient was immediately resuscitated and promptly transferred for surgical embolectomy under cardiopulmonary bypass.
A long segment of embolus traversing through the tricuspid valve and extensive bilateral pulmonary artery embolus were removed.
IVC filter was placed for a persistent right lower extremity DVT.
Hypercoagulable work-up was negative.
Patient continued to do well after discharge on Coumadin.
Open embolectomy offers great promises where there is no consensus in optimal management approach in such patients.
Bedside echocardiogram is vital in risk stratification and deciding choice of advanced PE treatment.
American Psychological Association (APA)
Acharya, Gyanendra Kumar& Adedayo, Ajibola Monsur& Prabhu, Hejmadi& Brinster, Derek R.& Mir, Parvez. 2015. Right Heart Transvalvular Embolus with High Risk Pulmonary Embolism in a Recently Hospitalized Patient: A Case Report of a Therapeutic Challenge. Case Reports in Pulmonology،Vol. 2015, no. 2015, pp.1-4.
https://search.emarefa.net/detail/BIM-1059877
Modern Language Association (MLA)
Acharya, Gyanendra Kumar…[et al.]. Right Heart Transvalvular Embolus with High Risk Pulmonary Embolism in a Recently Hospitalized Patient: A Case Report of a Therapeutic Challenge. Case Reports in Pulmonology No. 2015 (2015), pp.1-4.
https://search.emarefa.net/detail/BIM-1059877
American Medical Association (AMA)
Acharya, Gyanendra Kumar& Adedayo, Ajibola Monsur& Prabhu, Hejmadi& Brinster, Derek R.& Mir, Parvez. Right Heart Transvalvular Embolus with High Risk Pulmonary Embolism in a Recently Hospitalized Patient: A Case Report of a Therapeutic Challenge. Case Reports in Pulmonology. 2015. Vol. 2015, no. 2015, pp.1-4.
https://search.emarefa.net/detail/BIM-1059877
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1059877