Right heart thrombus: Recognition, diagnosis and management

Abstract

The clinical, echocardiographic, hemodynamic, angiographic and pathologic features of five patients who had right heart thrombus are presented and their management is discussed. Two modes of presentation were recognized. In four patients, right heart thrombus complicated peripheral venous thrombosis and was associated with major pulmonary thromboembolism and right heart obstruction. In the fifth, it complicated myocarditis with heart failure and appeared to cause right heart obstruction. Two-dimensional echocardiography was diagnostic of right heart thrombus in four patients and showed evidence of right heart dysfunction in those with major pulmonary thromboembolism. The diagnosis was confirmed at surgery in three patients and at autopsy in one. Three patients successfully underwent surgical removal of the thrombus followed by anticoagulation. One patient was treated successfully with anticoagulation alone. The only death occurred in the patient with myocarditis.

Management of mobile right heart thrombi: a prospective series

“…MRHT can be observed [8] by echocardiography [9] in 4 -18% of patients of severe PE [10]. Before the development of echocardiography, MRHT were identified at autopsy.…”

Infected Right Atrial Thrombus: Serious Complication of Intravenous Fluid Replacement Catheter

“…We would like to emphasize that there is a continued debate in the literature on the treatment of right atrial thrombus: the conservative approach with drug therapylo-12 vs the surgical approach. 13 …”

Erfahrungen in der Diagnostik und Therapie von sogenannten “Transitthromben”

“…Bei Verdacht auf eine Lungenembolie wird heute die zweidimensionale transthorakale Echokardiographie als eine der ersten diagnostischen Maßnahmen gesehen (5,16,25). Durch die zunehmende Verbreitung der Methode, auch in Aufnahme-und Intensivstationen kann der oft nur kurzfristig mögliche Nachweis von Transitthromben im rechten Herzen gelingen.…”