Witnessing a rare event – thrombus seeking its route in the right atrium: ‘thrombus-in-transit’

Abstract

Pulmonary embolus and right atrial thrombus trapped in a patent foramen ovale is an unusual, rare condition. We report a case of impending paradoxical embolism with pulmonary embolism, in which a thrombus entrapped in a patent foramen ovale was detected. To our knowledge, this is the first case in the literature in which 'thrombus-in-transit' was detected in the right atrium both before and after entrapment in a patent foramen ovale.

A rare case of concurrent multichamber thrombosis complicated by cardioembolic stroke in a reversible postpartum thyrotoxic cardiomyopathy

“…The peculiarities of our case report are that this type of reversible-dilated cardiomyopathy was described only in one case report 3. The role of PFO diagnosed by TOE in cryptogenic stroke was described since 2000,4 but only few articles demonstrated the real existence of ‘thrombus-in-transit’ 5 6…”

Acute Coronary Syndrome Followed by Pulmonary Thromboembolism and Identification of a Large Fixed Thrombus between Atria in a Patient with Severe COVID-19: A Case Report

“…9 Its identification requires immediate and timely treatment, especially due to the possible outcome of pulmonary or paradoxical systemic embolism. 2 If that occurs, the brain is the most frequently affected organ, followed by the coronary arteries. 1 It is not possible to state whether the identified interatrial thrombus was formed from the progression of a thrombus formed at the site or whether it was secondary to the expansion of an embolus from the lower limb or pelvis to the pulmonary artery, eventually "captured" by the PFO.…”

“…1 When visualized, they represent a major clinical challenge and require emergency treatment. 2 The severity of this condition becomes even more accentuated when associated with other thrombotic events, such as pulmonary embolism. 3 In turn, these events may have their genesis in hyperinflammatory states with high thrombogenic and angiopathic potential, as in the case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.…”

Thrombus in Transit through Patent Foramen Ovale

“…The incidence of PFO is around 27% through all ages [1–3]. This passage needs a higher right than left atrial pressure, which happens in the context of pulmonary embolism (PE) or pulmonary hypertension [4]. …”