Right atrial thrombus migration during echocardiography: a case for urgent intervention.
A 65-year-old woman presented with increasing shortness of breath, chest pain and ST-T wave abnormalities on the electrocardiogram suggestive of unstable angina. Cross-sectional echocardiography performed to assess wall-motion abnormality and left ventricular function revealed a pedunculated right atrial thrombus prolapsing into the right ventricle which suddenly dislodged and migrated into the pulmonary circulation during the examination. A diagnosis of recurrent pulmonary thromboembolism was made, necessitating urgent pulmonary angiography with infusion of streptokinase. The patient made an uneventful recovery.
Senior
R
R
Northwick Park Hospital, Harrow Middlesex, U.K.
Cowell
R
R
Thomas
P
P
Raftery
E B
EB
D000368:Aged; D004630:Emergencies; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006331:Heart Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D013923:Thromboembolism / Q000000981:diagnostic imaging; D013927:Thrombosis / Q000000981:diagnostic imaging*; D014463:Ultrasonography