Echocardiographic diagnosis of a giant thrombus passing through a patent foramen ovale from right atrium to the left atrium

Abstract

Pulmonary embolus sourced by right atrial thrombus trapped in a patent foramen ovale is an unusual, rare condition. Thus in suspicion of massive pulmonary thromboembolus, echocardiographic examination carries great importance evaluate right ventricular functions and diagnose right sided intracardiac thrombus. We report a 76-year-old female with massive pulmonary embolism caused by a gigantic thrombus trapped in a patent foramen ovale. The echocardiography was the diagnostic procedure to display the source of the thromboembolism and urgent cardiac surgery was successful and life-saving treatment in this case.

Successful treatment of mobile right atrial thrombus and acute pulmonary embolism with intravenous tissue plasminogen activator

“…Mobile thrombus in the right atrium when present along with pulmonary embolism is associated with increased mortality of more than 40% 8. The workup of pulmonary embolism requires systematic echocardiography, one of the objectives of which is to search for right-sided thrombi and echocardiography is a useful non-invasive, readily available test to diagnose right-sided thrombus 9. Current therapeutic options for treatment of right atrial thrombi include thrombolysis, surgical embolectomy or percutaneous embolectomy; however, the most effective therapy remains unknown.…”

A 57-Year-Old Man With Insidious Dyspnea and Nonpleuritic Chest and Back Pain

“…[11][12][13][14] Given impaired hemodynamics and oxygen exchange, this patient would likely not have tolerated the additional burden of emboli to the pulmonary circulation and ongoing risk of paradoxical arterial embolization predisposing to myocardial infarction and further stroke. 12,15,16 Imaging Discussion…”

Left atrial thrombus in a patient without mitral valve disease or atrial fibrillation

“…The possibility of PFO cannot be excluded owing to the dense adhesion of thrombus attached to the septum and the organized and not floating calcified thrombus formation, which suggests a long history of thrombus formation. Previous reports had described a floating LA thrombus which had grown from the right atrial side through the PFO, causing systemic thromboembolism [11,12].…”