A sixty-eight-year-old woman with a clinical diagnosis of pulmonary embolism and large right-heart embolus on echocardiography is presented. Because of the critical clinical condition of the patient and the inability to perform surgical intervention, thrombolytic treatment (streptokinase) was administered. The patient's condition improved, the right-heart embolus disappeared, and on the perfusion lung scan there was only one small perfusion defect in the right lung. The authors consider thrombolysis to be appropriate treatment for right-heart thromboembolism whenever surgical embolectomy is not possible.
Get full access to this article
View all access options for this article.
References
1.
Farfel Z., Schechter M., Vered Z., et al: Review of echocardiographically diagnosed right heart entrapment of pulmonary emboli-in-transit with emphasis on management. Am Heart J113:171-178, 1987.
2.
Crowell RH, Adams GS, Koilpillai CJ, et al: In vivo right heart thrombus. Precursor of life-threatening pulmonary embolism. Chest94:1236-1239, 1988.
3.
Eskilsson J. , Tallroth G.: Spontaneous disappearance of right atrial thromboembolus without pulmonary embolism. Acta Cardiol41:301-304, 1986.
4.
Høegholm A., Clementsen P., Mortensen SA: Syncope due to right atrial thrombolembolism: Diagnostic importance of two-dimensional echocardiography. Acta Cardiol42:469-473, 1987.
5.
Starkey IR, deBono DP: Echocardiographic identification of right-sided cardiac intracavitary tromboembolus in massive pulmonary embolism. Circulation66:1322-1325, 1982.
6.
Parris TM, Panidis IP, Ross J., et al: Right atrial thromboembolism with clinically silent pulmonary emboli. Am J Noninvas Cardiol1:254-256, 1987.
