Fatal evolution of a huge right atrial free‐floating thrombus

Bodian, Malick; Bâ, F.; Jobe, Modou; Ndiaye, Mouhamadou Bamba; Kané, A.; Sarr, Simon Antoine; Mbaye, A.; Gaye, Abdou Majib; Thiam, Ibou; Diao, Maboury; Sarr, M.; Bâ, Serigne Abdou

doi:10.1002/ccr3.25

Cited by 6 publications

(8 citation statements)

References 9 publications

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“…FFRHT and PE were observed together. In a series by Chartier et al 8 , on the day of admission, almost 21.1% of patients died, and the hospital mortality rate was 44.7% in patients who had a large RHT due to the occurrence of a sudden pulmonary embolism.…”

Section: Discussionmentioning

confidence: 93%

Diagnostic and therapeutic challenge: A case of right ventricular thrombus

Bedi,

Sabri,

Sevella

et al. 2024

gcsp

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Right ventricular thrombus is a rare finding found in 4% of people diagnosed with pulmonary embolism. Although right ventricular thrombi are usually associated with atrial fibrillation, deep venous vein thrombi, or intracardiac procedures, isolated right ventricular thrombi are rare. Right ventricular thrombus has also been reported in patients with right ventricular infarction, as hypokinesis of the right ventricle causes blood stasis and promotes thrombosis as per Virchow’s triad. However, we present a case of isolated RV thrombus in a patient without evidence of deep vein thrombosis or right ventricular hypokinesis who presented with dyspnea on exertion.

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Section: Discussionmentioning

confidence: 93%

Diagnostic and therapeutic challenge: A case of right ventricular thrombus

Bedi,

Sabri,

Sevella

et al. 2024

gcsp

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“…Sağ atriumdaki trombüsle ilgili olgular ilk kez 1980'li yıllarda yayımlanmaya başlanmıştır ve bu olgular pulmoner emboli geçiren hastalarla ilgilidir. 3 Sağ atriyumdaki trombüsler, sıklıkla ince ve uzun yapıda olup, çok hareketli, yılanvari (serpenjinöz) ve filiform yapıdadırlar. Sağ atriyumda lokal olarak gelişebilecekleri gibi, sıklıkla derin venlerden ya da venöz yatağın başka bölgelerinden embolize olup sağ atriyuma ilerleyebilirler.…”

Section: Discussionunclassified

“…Bununla birlikte; bu hastaların tedavisinde olabilecek herhangi bir erteleme ya da gecikme ölümcül seyredebilmektedir. 3 Burada pulmoner emboli kliniğiyle başvuran ve transtorasik ekokardiyografide sağ atriyumda hareketli, yaygın ve yılanvari trombüs saptanan bir hastanın takdim edilmesi ve benzer olgularda uygun tedavi stratejilerinin tartışılması amaçlandı. Pulmoner emboli tanısı zor konan ve morbidite ve mortalitesi yüksek olan bir hastalık olup prognozu etkileyen en önemli faktörlerden biri doğru ve hızlı bir şekilde tanıya ulaşmaktır.…”

Section: Introductionunclassified

A Case Of Pulmonary Embolism Due To Serpentine-Like Right Atrial Thrombus

Öztürk¹,

Memioğlu²,

Dönmez³

et al. 2015

Sakarya Med J

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Sağ atriyumda trombüs varlığı pulmoner emboli için yüksek risk teşkil etmektedir ve tespit edildiğinde hemen tedavi başlatılmalıdır. Trombolitik tedavi, cerrahi embolektomi, antikoagülasyon tedavi seçenekleridir. Fakat tedavi seçimi konusunda net bir görüş birliği yoktur. Bu yazıda; kliniğimize çarpıntı, nefes darlığı, senkop şikayetleriyle başvuran ve sağ atriyumda hareketli, yaygın, yılanvari trombüs tespit ettiğimiz bir olguyu anlatmayı amaçladık.

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“…Deep vein thrombosis and pulmonary embolism (PE) are common, but right heart thrombus (RHT) is detected in less than 5% of cases of thromboembolic disease. [1][2] PE with RHT is associated with poor outcomes, especially in the absence of immediate treatment. [1][2][3][4] Indeed, the majority of deaths occur in the first 24 hours (62%).…”

Section: Introductionmentioning

confidence: 99%

“…[1][2] PE with RHT is associated with poor outcomes, especially in the absence of immediate treatment. [1][2][3][4] Indeed, the majority of deaths occur in the first 24 hours (62%). However, optimal management of PE with RHT remains unclear and there is a lack of randomized studies to support recommendations for disease management.…”

Section: Introductionmentioning

confidence: 99%

Case of a floating right atrial thrombus successfully treated with fibrinolysis

et al. 2019

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Mobile right atrial thrombi are at high risk of causing massive pulmonary embolism and are a medical emergency. This type of thrombus is identified in about 4-18% of pulmonary embolism cases. The presence of a free-floating embolic mass in right atrial or ventricle is often mortal: the death rate can reach 27%. Although surgery is commonly indicated, fibrinolysis is a therapeutic alternative. Here, a 58-year-old man presented to the emergency department for acute dyspnea associated with a painful right leg. Initial exams showed a shunt effect on blood gases with increased brain natriuretic peptide. Transthoracic echography (TTE) found a free-floating thrombus in the right atrium with signs of pulmonary hypertension and right ventricular dysfunction. Bilateral pulmonary embolism was confirmed by computed tomography angiography. Because there were signs of acute cor pulmonale and no contraindications, treatment with systemic fibrinolysis was decided. The treatment was delivered in intensive care unit and a cardiac surgical team was available. Subsequent clinical improvement was observed. TTE follow up at 12 hours revealed complete thrombus dissolution. There were no complications, in particular no hemorrhage. The patient was discharged after eleven days. At 6 months of follow-up, outcomes with oral anticoagulation therapy were satisfactory. Scintigraphy found good symmetrical perfusion of both lungs with stackable ventilation. TTE at 1 year showed preserved left and right ventricular function with no sign of pulmonary arterial hypertension and no thrombus recurrence. Systemic fibrinolysis appears to be a good alternative to surgery in this case.

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Fatal evolution of a huge right atrial free‐floating thrombus

Abstract: Key Clinical MessageRight atrial thrombus is a rare medical emergency that should be suspected in all cases of pulmonary embolism, and rapid action should be taken to ensure a timely, proper management.

Cited by 6 publications

References 9 publications

Diagnostic and therapeutic challenge: A case of right ventricular thrombus

Diagnostic and therapeutic challenge: A case of right ventricular thrombus

A Case Of Pulmonary Embolism Due To Serpentine-Like Right Atrial Thrombus

Case of a floating right atrial thrombus successfully treated with fibrinolysis

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