title: "Thrombus in transit"--the role of echocardiography in the diagnosis of massive pulmonary embolism and a review of the literature.
abstract: 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.
authors.affiliation: Department of Medicine, Our Lady's Hospital, Navan, Ireland. jimon@gofree.indigo.ie
authors.forename: James Oliver
authors.initials: JO
authors.lastname: O'Neill
authors.forename: Rashid
authors.initials: R
authors.lastname: Iqbal
authors.forename: Kathleen
authors.initials: K
authors.lastname: McGarry
mesh_terms: 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
chemical_list: D005343:Fibrinolytic Agents; D006493:Heparin