“Saved by the Pacing Catheter”: Gigantic Right Atrial Thromboembolus as a Cause of Pulmonary Embolism

  • Ana Isabel Costa Internal Medicine Department, Central Hospital of Funchal SESARAM, Funchal
  • Joana Jacinto Internal Medicine Department, Central Hospital of Funchal SESARAM, Funchal
  • Tiago Freitas Internal Medicine Department, Central Hospital of Funchal SESARAM, Funchal
  • Pedro Freitas Internal Medicine Department, Central Hospital of Funchal SESARAM, Funchal
  • Maria Luz Brazão Internal Medicine Department, Central Hospital of Funchal SESARAM, Funchal

Keywords

Pulmonary embolism, right heart thromboembolus, deep venous thrombosis, thrombolysis

Abstract

Pulmonary embolism (PE) related to the presence of right heart thromboemboli entails a higher mortality rate than PE alone. Furthermore, right heart thromboemboli are often associated with deep venous thrombosis. The most effective therapy for haemodynamically stable patients remains unknown, although recent data suggest that thrombolytic therapy is associated with a better outcome. We describe the case of an 83-year-old woman, hospitalized with PE consequent to right heart thrombus-in-transit, in whom investigation revealed a concomitant deep venous thrombosis. She required thrombolysis, given the high mortality risk that is traditionally associated with this clinical entity.

VIEW THE ENTIRE ARTICLE

References

  • Chartier L, Bera J, Delomez M et al. Free floating thrombi in right heart: diagnosis, management and prognostic indexes in 38 consecutive patients. Circulation 1999;99:2779–2783.
  • Covarrubias EA, Sheikh MU, Fox LM. Echocardiography and pulmonary embolism. Ann Intern Med 1977;87:720.
  • European Working Group on Echocardiography. The European Cooperative Study on the clinical significance of right heart thrombi. Eur Heart J 1989;10:1046–1059.
  • Pierre-Justin G, Pierard LA. Management of mobile right heart thrombi: a prospective series. Int J Cardiol 2005;99:381–388.
  • Rose P, Punjabi N, Pearse D. Treatment of right heart thromboemboli. Chest 2002;121:806–814.
  • Published: 2015-02-23

    Issue: Vol. 2 No. 1 (2015) (view)

    Section: Articles

    How to cite:
    1.
    Costa AI, Jacinto J, Freitas T, Freitas P, Brazão ML. “Saved by the Pacing Catheter”: Gigantic Right Atrial Thromboembolus as a Cause of Pulmonary Embolism. EJCRIM 2015;2 doi:10.12890/2015_000176.

    Most read articles by the same author(s)