Echocardiography and Pulmonary Embolism

Floating Right Heart Thrombi and Pulmonary Embolism: Diagnosis, Outcome and Therapeutic Management

“…A study of 477 consecutive autopsy findings did show a right cavity thrombus in 30 cases, with only 3 mobile thrombi and associated PE in 80% of cases [6]. Many echographic findings of right heart thrombi have been described since the first report of Covarrubias in 1977 [1][2][3][4][5][7][8][9][10][11][12][13]; however, prospective studies are scarce and deal with a small number of patients.…”

“…In view of this imminent pulmonary embolism (PE), many questions arc raised and remain unanswered: its frequen cy is not precisely known, diagnosis may be difficult to make and there is no agreement on therapeutic decisions: the usually associated massive PE docs not make the clini cian's task easier [1][2][3][4][5].…”

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

“…Predisposing factors include indwelling wires/catheters, dilated cavities, atrial fibrillation (Afib), prothrombotic states and other potential embolic sources. Ante-mortem diagnosis was unusual before the advent of echocardiography, being first described by Covarrubias et al [2] in 1977. Right-sided cardiac intracavitary thromboembolus, unlike local thrombosis, consists of embolic material that is temporarily lodged in the right atrium or ventricle, a condition frequently associated with deep venous thrombosis.…”

“…The embolus' fixation point is normally seen as a narrow pedicle. The echocardiographic characteristics are important to distinguish it from a mural thrombus, which has less mobility, a wider implantation base and the occasional presence of small focal calcifications [2,3] . The true incidence is not known, although it is estimated to be between 3% and 23% in patients with PE.…”

“…The true incidence is not known, although it is estimated to be between 3% and 23% in patients with PE. Right atrium thromboembolusrelated PE is associated with a higher mortality rate (30%) than PE alone (8%) [2,3,4] . Despite this evidence, there is no consensus on the best therapeutic approach.…”