title: Serpentine-like right atrial mass and fulminant bilateral pulmonary embolism during treatment with rivaroxaban.
abstract: Imaging work-up of a 80-year-old woman with sudden onset of dyspnea during current rivaroxaban therapy: computer tomography angiography revealed fulminant bilateral pulmonary embolism. Furthermore, a serpentine-like huge mass in the right atrium was detected, highly suggestive of thrombus or a giant chiari network, respectively. This case highlights the importance of adequate dose regimen of factor Xa inhibitors, as well as the need of thorough differential diagnostic considerations of net like structures in the right atrium.
authors.affiliation: University Clinic of Radiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. a.mayr@i-med.ac.at.
authors.forename: Agnes
authors.initials: A
authors.lastname: Mayr
authors.affiliation: University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Gert
authors.initials: G
authors.lastname: Klug
authors.affiliation: Division of Cardiology, Robert Bosch Medical Center, Auerbachstrasse 110, 70376, Stuttgart, Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Greulich
authors.affiliation: University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Metzler
authors.affiliation: University Clinic of Radiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Gudrun
authors.initials: G
authors.lastname: Feuchtner
mesh_terms: D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D000072226:Computed Tomography Angiography; D054796:Drug Dosage Calculations; D057915:Drug Substitution; D004417:Dyspnea / Q000209:etiology; D065427:Factor Xa Inhibitors / Q000008:administration & dosage*; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D011720:Pyrazoles / Q000008:administration & dosage; D011728:Pyridones / Q000008:administration & dosage; D000069552:Rivaroxaban / Q000008:administration & dosage*; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome
chemical_list: D065427:Factor Xa Inhibitors; D011720:Pyrazoles; D011728:Pyridones; C522181:apixaban; D006493:Heparin; D000069552:Rivaroxaban
keywords: Chiari network; Pulmonary embolism; Right atrial mass; Rivaroxaban; Thrombus