A Thrombus in Transit Complicating Acute Pulmonary Embolism

Alajaji, Wissam; MacSwords, Jacqui; Eapen, Sarah; Espinal, Eric; Pietrolungo, Joseph

doi:10.1016/j.jaccas.2019.09.022

Cited by 4 publications

(4 citation statements)

References 6 publications

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“…When a patient presents with an atrial thrombus, while in SR, the etiology of this finding must be further investigated. While the presence of the RA thrombi in the setting of submassive PE (defined as hemodynamic stability with right heart strain), is an occasional finding (although more common in massive PE defined as hemodynamic instability plus right heart strain), it is the concomitant LA thrombus that has created this clinical dilemma [1].…”

Section: Discussionmentioning

confidence: 99%

“…A shunt between the venous and arterial system, or RA to LA, known as paradoxical emobli, is a possibility for the patient's findings. The most common transatrial shunt is a PFO, which is found in about 25% of patients [1]. Other less common causes of shunts are extracardiac arteriovenous connections, like a patent ductus arteriosus or pulmonary arteriovenous fistula [7].…”

Section: Discussionmentioning

confidence: 99%

“…Intracardiac thrombi typically develop in the setting of multiple underlying disorders. Right atrial (RA) thrombi are occasionally found with pulmonary embolism (PE), or under the setting of atrial fibrillation (AF), but are rarely found in sinus rhythm (SR) [1,2]. Left atrial (LA) thrombi are most commonly found in the setting of AF, and sometimes with severe mitral valve disease, and like RA thrombi are almost never found in a patient in SR [3].…”

Section: Introductionmentioning

confidence: 99%

“…To take this one step further, the development of biatrial thrombi in the setting of SR, is an even rarer phenomenon. There are only a handful of case reports that describe the finding of biatrial thrombi in the setting of SR [1,2,4,5]. In the cases presented by Oe, et al [2] and Arslan, et al [4], the of biatrial thrombi and the indication to rule out a PFO.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Case Report: A Rare Case of Biatrial Thrombus in the Absence of Interatrial Shunt

Paul¹,

Nunez²,

T³

et al. 2021

Clin Med Rev Case Rep

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Case Report: A Rare Case of Biatrial Thrombus in the Absence of Interatrial Shunt

Paul¹,

Nunez²,

T³

et al. 2021

Clin Med Rev Case Rep

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Thrombus in transit associated with fatal pulmonary thromboembolism in an elderly Ethiopian man following a surgical procedure: A case report

Ahmed,

Solela

2024

Clinical Case Reports

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Key Clinical MessageEarly detection, timely management, and exploration of alternative treatment options are crucial for patients with high‐risk pulmonary thromboembolism, particularly those with thrombus in transit. Furthermore, prophylactic measures against thromboembolic events should be highly considered for patients with predisposing conditions for venous thromboembolism, including surgical procedures.AbstractA thrombus in transit refers to a thrombus that is temporarily lodged in the right‐side chambers of the heart with a high risk of embolization to the pulmonary artery. A 75‐year‐old man presented to the emergency department with a sudden onset of retrosternal chest pain for an hour associated with shortness of breath, which developed a week after transurethral resection of the prostate was done for the indication of benign prostatic hyperplasia. The physical examination was remarkable for tachycardia, tachypnea, hypoxia, and raised jugular venous pressure. Echocardiography revealed a serpiginous echogenic density in the right atrium, protruding through the tricuspid valve and extending to the right ventricle. He was put on facemask oxygen, and he received anticoagulation with unfractionated heparin, followed by thrombolytic therapy with streptokinase. However, the patient experienced cardiac arrest during the administration of thrombolytic therapy, and he died despite all the efforts, most likely due to a massive pulmonary thromboembolism resulting from the thrombus in transit. This case report has brought attention to the rare occurrence of a thrombus in transit complicated by fatal pulmonary thromboembolism. It has also highlighted the significant mortality risk that this condition carries, even with thrombolytic therapy.

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Typical chest pain and dyspnoea in a young man with a history of intravenous drug use

Gong

Burton

2020

Heart

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A Thrombus in Transit Complicating Acute Pulmonary Embolism

Abstract: A 51-year-old man presented with acute pulmonary embolism. He was found to have a large intracardiac thrombus in transit across a patent foramen ovale. He underwent anticoagulation and urgent surgical thrombectomy with good outcome. ( Level of Difficulty: Beginner. )

Cited by 4 publications

References 6 publications

Case Report: A Rare Case of Biatrial Thrombus in the Absence of Interatrial Shunt

Case Report: A Rare Case of Biatrial Thrombus in the Absence of Interatrial Shunt

Thrombus in transit associated with fatal pulmonary thromboembolism in an elderly Ethiopian man following a surgical procedure: A case report

Typical chest pain and dyspnoea in a young man with a history of intravenous drug use

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