Title: Right atrial mobile thrombus in patientwith acute, massive pulmonary embolism
- Michał Ciurzyński, Małgorzata Mikaszewska-Sokolewicz, Danuta Liszewska-Pfejfer, Andrzej Biederman, Ewa Mayzner-Zawadzka, Jerzy Małysz, Barbara Lichodziejewska
- Case Reports
- Polish Journal of Cardiology
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- Final page:
- right ventricular mobile thrombus, pulmonary embolism, echocardiography
A 71-year old man suffering from uteterolithiasis was admitted to the Department of Urology University of Warsaw - Infant Jesus Hospital and scheduled for percutaneous nephrolithotrypsy. On the sixth postope-rative day the patient required admission to the intensive care unit due to the clinical and biochemical signs of respiratory insufficiency. To diagnose the acute pulmonary embolism the transthoracic echocardiogra-phic examination (TTE) in Echocardiography Laboratory of Department of Internal Medicine and Cardiolo-gy was performed. TTE showed in the right atrium a highly mobile, longitudinal, additional echo attached to the interatrial septum in the place of foramen ovale, prolapsing in diastole into the right ventricle. After that TTE showed typical echocardiographic signs of acute massive pulmonary embolism. The patient was im-mediately transferred to Cardiac Surgery Unit in the Institute of Cardiology and on surgery longitudinal thrombus in foramen ovale and massive, fresh thrombi in lobar branches of the right and left pulmonary arteries were found. Unfortunately after embolectomy had been performed, the attempts to wain the patient from cardiopulmonary by-pass failed due to insufficient right ventricle. Discussion demonstrates the methods of treatment of the patients with acute pulmonary embolism and right atrial mobile thrombus.