[Intracardiac floating thrombi in patients with acute pulmonary thromboembolism].
The mortality and morbidity associated with residual intracardiac floating thrombi in patients with acute pulmonary thromboembolism remain uncertain. Thirteen patients (2 men and 11 women, mean age 56 +/- 15 years) with pulmonary thromboembolism underwent echocardiography within 24 hours from onset of symptoms. Four patients (31%) had floating intracardiac thrombi in the right heart: 3 in the right atrium and one in the inferior vena cava. The time to evaluation by echocardiography was shorter than in the patients without thrombi. The thrombi disappeared shortly (3.2 +/- 2.4 hr) after thrombolysis without adverse effects in these patients. After thrombolysis, clinical symptoms improved and pressure gradient between the right ventricle and right atrium decreased significantly (p < 0.01) from baseline 47 +/- 6 to 26 +/- 5 mmHg. Major bleeding complications occurred in 3 (43%) of the patients who underwent thrombolysis. Right-side intracardiac floating thrombus was easily detectable by early echocardiography. Thrombolytic agents are likely to be effective in patients with intracardiac floating thrombi.
Ikeda
R
R
Second Department of Internal Medicine, Sapporo Medical University School of Medicine.
Yuda
S
S
Nakahara
N
N
Kobayashi
N
N
Uno
K
K
Nakata
T
T
Tsuchihashi
K
K
Shimamoto
K
K
D000208:Acute Disease; D000328:Adult; D000368:Aged; D004452:Echocardiography; D005260:Female; D006331:Heart Diseases / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010960:Plasminogen Activators / Q000627:therapeutic use; D011655:Pulmonary Embolism / Q000150:complications* / Q000473:pathology; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000209:etiology* / Q000473:pathology; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use
D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator