[Embolism in the right heart chambers: the diagnostic and therapeutic aspects].
Deep venus thrombosis may result in pulmonary embolism. In rare instances, embolization has occurred, not directly to the pulmonary arterial tree, but to the right heart chambers. Although the value of echocardiography in the diagnosis is well recognised, their is no consensus for the appropriate treatment. We report herein six cases of floating right atrial thrombi, diagnosed by echocardiography, in patients with pulmonary embolism, or unexplained shock or syncope. Surgical embolectomy was carried out in 4 patients, and thrombolytic therapy in 2, without in-hospital mortality. The high mortality associated to this entity may be improved by rapid echocardiographic recognition and emergency treatment with thrombolysis or surgery. Our data suggest the possible use of thrombolysis as a first-choice therapy in selected patients.
Merino Cejas
C M
CM
Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España.
Casares Mediavilla
J
J
Alados Arboleda
P J
PJ
Porras Martín
C
C
Legarra Calderón
J J
JJ
Muñoz Carvajal
I
I
Mesa Rubio
D
D
Concha Ruiz
M
M
D000328:Adult; D000368:Aged; D004359:Drug Therapy, Combination; D004452:Echocardiography; D017128:Embolectomy / Q000379:methods; D004617:Embolism / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006331:Heart Diseases / Q000175:diagnosis* / Q000628:therapy; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D011877:Radionuclide Imaging; D013300:Streptokinase / Q000008:administration & dosage; D015912:Thrombolytic Therapy; D014692:Ventilation-Perfusion Ratio
D005343:Fibrinolytic Agents; D006493:Heparin; D013300:Streptokinase