Right Ventricular Thrombus in Transit: Raising the Stakes in the Management of Pulmonary Embolism

Lai, Everett; Alishetti, Shudhanshu; Wong, Jonathan; Delić, L.; Rosenblatt, Alberto; Egrie, Glenn

doi:10.1016/s0735-1097(19)33450-3

Cited by 11 publications

(9 citation statements)

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“…RV thrombi, or CITs, are uncommon, occurring in about 4% of unselected patients with PE, but are associated with a considerable 27% to 45% mortality rate. [4][5][6] Optimal therapy for CIT is not defined, as most data are based on case series or registry results. However, meta-analytic data suggest superior results with thrombolytic therapy in these patients compared with alternative treatment modalities.…”

Section: Discussionmentioning

confidence: 99%

Clot in Transit in a Patient with COVID-19: Transesophageal Echocardiographic Guidance of Mechanical Cardiopulmonary Resuscitation

Horowitz¹,

Yuriditsky²,

Bakker³

et al. 2021

CASE

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Section: Discussionmentioning

confidence: 99%

Clot in Transit in a Patient with COVID-19: Transesophageal Echocardiographic Guidance of Mechanical Cardiopulmonary Resuscitation

Horowitz¹,

Yuriditsky²,

Bakker³

et al. 2021

CASE

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“…9 CIT is uncommon, occurring in about 4% of unselected patients with PE, but is associated with a considerable mortality rate of 27% to 45%. 10,11 In patients with right ventricular dysfunction, CIT raises significant suspicion for PE. Although TEE is not the modality of choice for the diagnosis of PE, our choice of imaging modalities was limited, and TEE was further used to characterize chamber size and function to assist with the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Clot in Transit on Transesophageal Echocardiography in a Prone Patient with COVID-19 Acute Respiratory Distress Syndrome

Horowitz¹,

Yuriditsky²,

Henderson³

et al. 2020

CASE

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“…Right ventricular thrombus on the other hand, often originates from systemic venous or tumour thrombosis. 11 It is a rare complication of anterior or inferior MI, 12 and associated with concomitant infarction of the RV apex. Our 2nd patient had a RV cystic mass together with a partial VSR, both of which were atypical.…”

Section: Discussionmentioning

confidence: 99%

A case series of ventricular cystic masses

Tong

Low

Francis

et al. 2020

European Heart Journal - Case Reports

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Background Ventricular cystic masses are uncommon. Elucidating the cause is essential for early directed therapy and prevention of complications. We present two cases of ventricular cystic masses, one in each ventricle, after myocardial infarction (MI) and ventricular septal rupture (VSR), respectively. Case summary Patient 1 is a 58-year-old male with left brachio-facial stroke and evolved anterior MI. A left ventricular (LV) cystic thrombus was seen on transthoracic echocardiogram (TTE) and cardiac magnetic resonance (CMR) imaging. He was started on anticoagulation with reduction in thrombus size 11 days later. Patient 2 is a 67-year-old male with evolved anterior MI, severe LV systolic dysfunction, and normal right ventricular (RV) function. He was readmitted two weeks later with fever, heart failure, Streptococcus agalactiae bacteraemia, and septic pulmonary emboli. Transthoracic echocardiogram showed biventricular systolic dysfunction and a RV cystic mass associated with a partial VSR. He was treated with anticoagulation and antibiotics. Repeat TTE 5 weeks later revealed near resolution of the cystic mass and complete VSR. Cardiac magnetic resonance confirmed these findings and also showed a localized mid-septal transmural infarction at the VSR site. He underwent percutaneous coronary intervention to the left anterior descending and circumflex arteries, and percutaneous VSR closure with a muscular ventricular septal defect device later. Discussion Our two cases demonstrate that ventricular thrombi can present as cystic masses after MI and VSRs. Infectious, vascular, or oncogenic causes should be considered in the appropriate clinical context. Early diagnosis and treatment is essential to prevent embolic complications, and secondary infection.

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Right Ventricular Thrombus in Transit: Raising the Stakes in the Management of Pulmonary Embolism

Cited by 11 publications

References 0 publications

Clot in Transit in a Patient with COVID-19: Transesophageal Echocardiographic Guidance of Mechanical Cardiopulmonary Resuscitation

Clot in Transit in a Patient with COVID-19: Transesophageal Echocardiographic Guidance of Mechanical Cardiopulmonary Resuscitation

Clot in Transit on Transesophageal Echocardiography in a Prone Patient with COVID-19 Acute Respiratory Distress Syndrome

A case series of ventricular cystic masses

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