"Thrombus in transit"--the role of echocardiography in the diagnosis of massive pulmonary embolism and a review of the literature.
The diagnosis of acute pulmonary embolus is often difficult. We present a case history where bedside transthoracic echocardiography provided a rapid and convenient aid to diagnosis by demonstrating a venous "thrombosis in transit" as a spiral shaped mass in the right atrium prolapsing into the right ventricle. We also review the management and outcome in recent, similar cases. Overall mortality is 33% for pulmonary embolus and associated thrombus in transit. Transthoracic echocardiography may be a useful tool in the diagnosis of pulmonary embolus. The presence of thrombus in the right heart is a rare finding. The outcome in these patients is determined by the clinical presentation rather than by the identification of thrombus.
O'Neill
James Oliver
JO
Department of Medicine, Our Lady's Hospital, Navan, Ireland. jimon@gofree.indigo.ie
Iqbal
Rashid
R
McGarry
Kathleen
K
D004452:Echocardiography; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000188:drug therapy; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D006493:Heparin