Thrombolysis for Right Atrial Thrombus-in-Transit in a Patient With Massive Pulmonary Embolism.
Right atrial thrombus is a rare entity frequently encountered in patients with pulmonary embolism. Although the existing guidelines do not offer a clear statement for the management of right atrial thrombus and pulmonary embolism, this condition is associated with worse outcomes. We present a case of a 79-year-old patient presenting with signs suggestive of massive pulmonary embolism who was found to have a right atrial thrombus on transthoracic echocardiogram and was successfully treated with systemic thrombolysis. Despite the lack of data from randomized studies, right atrial thombi in transit should be considered a severe form of thromboembolic disease often requiring aggressive treatment, particularly in patients with severe right ventricular dysfunction.
1Detroit Medical Center Cardiovascular Institute, Detroit, MI; and 2Department of Cardiology, Wayne State Univeristy, Detroit, MI.
Mahmoud
M
Othman
Alexandros
A
Briasoulis
Luis
L
Afonso
D000368:Aged; D004359:Drug Therapy, Combination; D004452:Echocardiography; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006325:Heart Atria / Q000000981:diagnostic imaging; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011152:Popliteal Vein / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000150:complications*; D015912:Thrombolytic Therapy / Q000379:methods*; D013927:Thrombosis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use; D020246:Venous Thrombosis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy
D005343:Fibrinolytic Agents; D006493:Heparin; D010959:Tissue Plasminogen Activator