Open AccessFree-Floating right heart thrombus with acute massive pulmonary embolism: A case report and review of the literature
Author(s) -
Fida Charif,
Mohamad Jihad Mansour,
Righab Hamdan,
Claudette Najjar,
Pierre Nassar,
Mohamad Issa,
Elie Chammas,
Mohamad Saab
Publication year - 2018
Publication title -
journal of cardiovascular echography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.255
H-Index - 8
eISSN - 2347-193X
pISSN - 2211-4122
DOI - 10.4103/jcecho.jcecho_64_17
Subject(s) - medicine , tenecteplase , pulmonary embolism , thrombus , context (archaeology) , pulmonary hypertension , cardiology , right heart , emergency department , radiology , thrombolysis , paleontology , psychiatry , myocardial infarction , biology
Free-floating right heart thrombus (RHT) is an extreme medical emergency in the context of acute massive pulmonary embolism (PE). Despite the advances in early diagnosis, the management is still very debatable due to lack of consensus. We reported the case of a 66-year-old male, with a history of moderate renal dysfunction and dilated cardiomyopathy, who presented to the emergency department for acute dyspnea. His angiographic magnetic resonance imaging revealed bilateral extensive PE. Transthoracic echocardiography showed RHT with moderate right ventricular dysfunction and pulmonary hypertension. Venous Doppler of the lower extremities noted the presence of a floating clot in the right common femoral vein. The patient was managed successfully by thrombolytic therapy with tenecteplase. To the best of our knowledge, this is the first case report of RHT and PE from Lebanon. Published cases from Middle Eastern countries are scarse.