Pulmonary Embolism and Intracardiac Type A Thrombus with an Unexpected Outcome
Joint Authors
Português, João
Calvo, Lucy
Oliveira, Margarida
Pereira, Vítor Hugo
Guardado, Joana
Lourenço, Mário Rui
Azevedo, Olga
Ferreira, Francisco
Canário-Almeida, Filipa
Lourenço, António
Source
Issue
Vol. 2017, Issue 2017 (31 Dec. 2017), pp.1-5, 5 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2017-04-02
Country of Publication
Egypt
No. of Pages
5
Main Subjects
Abstract EN
Detection of right heart thrombi (RHT) in the context of pulmonary thromboembolism (PE) is uncommon (4–18%) and increases the risk of mortality beyond the presence of PE alone.
Type A thrombi are serpiginous and highly mobile and are thought to be originated from large veins and captured in-transit within the right heart.
Optimal management of RHT is still uncertain.
A 79-year-old woman, with a history of recent total hysterectomy with adnexectomy and a Wells procedure, presented to the emergency department following an episode of syncope.
Computed tomography revealed bilateral PE and the presence of a right atrial thrombus.
Transthoracic echocardiography demonstrated a free-floating type A thrombus in the right atrium, protruding into the right ventricle, and signs of pulmonary hypertension and right ventricle dysfunction.
Considering the recent surgery and clinical stability, treatment with heparin alone was decided.
Subsequent clinical improvement was observed and echocardiographic follow-up revealed complete thrombus dissolution and complete recovery of right ventricle function.
Most authors recommend treatment of PE with RHT with thrombolysis or embolectomy followed by anticoagulation, although evidence is scarce.
Individual risk of hemorrhage and operatory-related mortality should be taken into account when defining the treatment strategy especially when benefit is not firmly established.
American Psychological Association (APA)
Português, João& Calvo, Lucy& Oliveira, Margarida& Pereira, Vítor Hugo& Guardado, Joana& Lourenço, Mário Rui…[et al.]. 2017. Pulmonary Embolism and Intracardiac Type A Thrombus with an Unexpected Outcome. Case Reports in Cardiology،Vol. 2017, no. 2017, pp.1-5.
https://search.emarefa.net/detail/BIM-1144242
Modern Language Association (MLA)
Português, João…[et al.]. Pulmonary Embolism and Intracardiac Type A Thrombus with an Unexpected Outcome. Case Reports in Cardiology No. 2017 (2017), pp.1-5.
https://search.emarefa.net/detail/BIM-1144242
American Medical Association (AMA)
Português, João& Calvo, Lucy& Oliveira, Margarida& Pereira, Vítor Hugo& Guardado, Joana& Lourenço, Mário Rui…[et al.]. Pulmonary Embolism and Intracardiac Type A Thrombus with an Unexpected Outcome. Case Reports in Cardiology. 2017. Vol. 2017, no. 2017, pp.1-5.
https://search.emarefa.net/detail/BIM-1144242
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1144242