title: Straddling interatrial embolus: a rare clinical dilemma.
abstract: We present the case of a middle-aged man who was admitted with progressive shortness of breath and haemodynamic instability. He was diagnosed as having unprovoked bilateral central pulmonary emboli. Thrombolysis with alteplase was provided. Subsequently, an echocardiogram was performed which showed a thrombus straddling the interatrial septum. This was managed conservatively with enoxaparin anticoagulation. A repeat echocardiogram 2 days later showed complete resolution of the thrombus without clinical systemic arterial thromboembolic sequelae such as stroke, myocardial ischaemia or acute limb ischaemia.
authors.affiliation: Department of Internal Medicine, Pennine Acute Hospitals NHS Trust, Bury, UK.
authors.forename: Elhosseyn
authors.initials: E
authors.lastname: Guella
authors.affiliation: Cardiology Department, The Royal Oldham Hospital, Oldham, UK.
authors.forename: Louis James
authors.initials: LJ
authors.lastname: Mitchell
authors.affiliation: Department of Cardiology, Pennine Acute Hospital Trust, Oldham, UK.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Sobolewska
authors.affiliation: Cardiology Department, The Royal Oldham Hospital, Oldham, UK.
authors.forename: Kamal
authors.initials: K
authors.lastname: Khan
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D004417:Dyspnea / Q000000981:diagnostic imaging* / Q000209:etiology; D004452:Echocardiography; D017984:Enoxaparin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin