scholarly journals Right Heart Thrombus in-Transit in Patient with Acute Pulmonary Embolism Treated by Thrombolytic Therapy with Tenectplase

2015 ◽  
Vol 3 (2) ◽  
pp. 11
Author(s):  
Warkaa Al Shamkhani
Keyword(s):  
Pulmonary Embolism ◽  
Thrombolytic Therapy ◽  
Acute Pulmonary Embolism ◽  
Right Heart ◽  
In Transit

scholarly journals Point-of-care Ultrasound Diagnosis of Pulmonary Embolism with Thrombus in Transit

2019 ◽  
Vol 3 (2) ◽  
pp. 11-12 ◽  
Author(s):  
Nicolas Kahl ◽  
Christopher Gabriel ◽  
Shadi Lahham ◽  
Maxwell Thompson ◽  
Wirachin Hoonpongsimanont
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Point Of Care ◽  
Skilled Nursing Facility ◽  
Point Of Care Ultrasound ◽  
Right Heart ◽  
Skilled Nursing ◽  
Chamber View ◽  
The Right ◽  
In Transit

A 95-year-old female with a history of dementia and atrial fibrillation (not on anticoagulation) presented to the emergency department (ED) by ambulance from her skilled nursing facility due to hypoxia. Point-of-care ultrasound was performed, and showed evidence of a large mobile thrombus in the right ventricle on apical four-chamber view. Further evidence of associated right heart strain was seen on the corresponding parasternal short-axis view. These ultrasound findings in combination with the patient’s clinical presentation are diagnostic of acute pulmonary embolism with right heart strain. Point-of-care transthoracic cardiac ultrasound in the ED is an effective tool to promptly diagnose acute pulmonary embolism with right heart strain and thrombus in transit and guide further treatment.

scholarly journals Free Floating Right Heart Thrombus Associated with Acute Pulmonary Embolism: An Unsettled Therapeutic Difficulty

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Clovis Nkoke ◽  
Olivier Faucher ◽  
Lise Camus ◽  
Laurence Flork
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Pulmonary Embolism ◽  
Thrombolytic Therapy ◽  
Right Ventricle ◽  
Transthoracic Echocardiography ◽  
Acute Pulmonary Embolism ◽  
Acute Onset ◽  
Optimal Management ◽  
Right Heart

Free floating right heart thrombus is a rare phenomenon in the context of acute pulmonary embolism and it is associated with a poor outcome. The increased use of echocardiography has led to an increased detection of right heart thrombi. However, optimal management of free floating right heart thrombus remains controversial with no clear consensus. We present the case of a 74-year-old woman who presented to the emergency department with acute onset dyspnea on minimal exertion which had developed over a period of 1 day. A computed tomography of the chest demonstrated massive bilateral proximal pulmonary embolism. A bedside transthoracic echocardiography performed showed a moderately dilated, poorly functioning right ventricle with visible highly mobile serpiginous thrombus moving to and fro across the tricuspid valve. Thrombolytic therapy was immediately initiated with tenecteplase which resulted in excellent results. Although there is no clear consensus for the management of right heart thrombus associated with pulmonary embolism, thrombolysis is readily available and can be effective in carefully selected patients.

scholarly journals Clot in transit: a case of acute pulmonary embolism

2020 ◽  
Vol 13 (8) ◽  
pp. e236494
Author(s):  
Jose Ruiz-Morales ◽  
William Kogler ◽  
Maedeh Ganji ◽  
Srinivasan Sattiraju
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
In Transit

scholarly journals RIGHT HEART THROMBI IN ACUTE PULMONARY EMBOLISM. IS IT AN OMINOUS SIGN OR A CALL FOR THROMBOLYSIS

2021 ◽  
Vol 77 (18) ◽  
pp. 1796
Author(s):  
Justin Paul Gnanaraj ◽  
Rajesh Sekar ◽  
Nilavan Asaithambi ◽  
Siva Subramaniyam Saravanan ◽  
Venkatesan Sangareddi ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Right Heart

Observation of Nursing Care of Patients with Acute Severe Pulmonary Embolism after General Surgery under Microscope

2021 ◽  
Vol 7 (5) ◽  
pp. 1459-1468
Author(s):  
Wenbin Liang ◽  
Jing Shen ◽  
Yuanling Zhang ◽  
Hongbing Li ◽  
Bangxing Yu
Keyword(s):  
Pulmonary Embolism ◽  
Thrombolytic Therapy ◽  
General Surgery ◽  
Acute Pulmonary Embolism ◽  
Clinical Medicine ◽  
Positive Impact ◽  
Survey Methods ◽  
Clinical Manifestations ◽  
Effective Rate ◽  
Treatment Rate

Acute pulmonary embolism (APE) is one of the common acute and critical illnesses in clinical medicine, and it is another high cause of death after heart disease, cancer and cardiovascular disease. Despite the unremitting research and exploration of many relevant experts in recent years, major progress has been made in diagnosis and treatment, but the clinical manifestations of acute pulmonary embolism are not specific, and there is a lack of effective and definite methods for diagnosis. The mortality rate of patients with acute pulmonary embolism remains high. Furthermore, the combination of multiple postoperative diseases caused by general surgery can also increase the mortality of patients. Based on this, this article uses microscope technology to study and analyze the pretreatment methods and nursing methods of patients with acute severe pulmonary embolism after general surgery to improve the condition of patients with acute pulmonary embolism and increase their recovery rate, hoping to be the domestic acute pulmonary embolism The treatment provides reference and reference. This article first summarizes the relevant theories of surgery and acute pulmonary embolism, and then uses experimental methods, data analysis methods, survey methods and comparison methods, and SPSS 22.0 statistical analysis software technology to observe the efficacy of patients after thrombolytic therapy through a microscope. It is concluded that in the sample data of 50 cases, the significant rate accounts for 58%, the effective rate accounts for 36%, and the inefficiency accounts for 6%, confirming the positive impact of early thrombolytic therapy on patients with acute pulmonary embolism. Finally, through the microscope observation and comparison of the patient’s physical signs before and after nursing, it is concluded that timely and effective nursing after surgery has a great effect on improving the treatment rate of patients.

scholarly journals ASSOCIATION BETWEEN REPERFUSION THERAPY AND OUTCOMES IN PATIENTS WITH ACUTE PULMONARY EMBOLISM AND RIGHT HEART THROMBI

2020 ◽  
Vol 75 (11) ◽  
pp. 2199
Author(s):  
Behnood Bikdeli ◽  
David Jimenez ◽  
Alfonso Muriel ◽  
Deisy Barrios ◽  
Aitor Ballaz ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Reperfusion Therapy ◽  
Right Heart

scholarly journals P689 Surgical treatment of a right heart thrombus-in-transit with massive bilateral pulmonary embolism

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
C M Angelescu ◽  
I Hantulie ◽  
Z Galajda ◽  
I Mocanu ◽  
A T Paduraru ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Right Atrium ◽  
Intracardiac Thrombus ◽  
Severe Pulmonary Hypertension ◽  
Right Heart ◽  
Right Pulmonary Artery ◽  
The Right ◽  
In Transit ◽  
Right Heart Dysfunction

Abstract Introduction Right heart thrombi are rare, found in up to 20% of pulmonary emboli (PE), and associated with significantly increased mortality(1). A thrombus entrapped in a PFO is a rare form of right heart thromboembolism. Clinical Case A 73-year-old male patient who had dyspnea for 10 days, was transferred to our hospital for the surgical treatment of a cardiac tumor. We performed TTE which revealed a free floating, huge mass( measuring more than 8 cm long) in the right atrium, that protruded in the right ventricle, with high risk of embolization. Another smaller mass, attached to the interatrial septum. Severe right ventricular dysfunction and severe pulmonary hypertension were present. Contrast-enhanced computer tomography was performed, which revealed severe bilateral pulmonary artery emboli with complete occlusion of right pulmonary artery branch. Clinical and paraclinical data strongly suggested that the huge cardiac mass was a thrombus that originated from the lower extremity veins. TEE showed that the thrombus was entrapped through the PFO, with a smaller part in the left atrium and the biggest portion in the right atrium. The patient underwent an emergent on-pump surgical cardiac and right pulmonary artery embolectomy. The right atrium was opened and a huge intracardiac thrombus with a lengh of 14 cm extending from the coronary sinus, to PFO in the left atrium and also in the right ventricle was removed. The right branch of the pulmonary artery was opened and a large volume of clot- 9 cm long- was removed. The patient was removed from cardio-pulmonary by-pass (CPB) on high doses of norepinephrine and dobutamine and necessitated initiation of venous-arterial ECMO to support the severe right heart dysfunction. He was extubated after 10 days, with little improvement in the clinical status. Transthoracic echocardiography showed smaller right heart cavities), normal left ventricular function, but persistent severe RV dysfunction and severe pulmonary hypertension. In the thirteenth postoperative day, he installed cardio-respiratory arrest and he died. Discussion In this report we describe a case of a patient with a huge intracardiac thrombus, entrapped through a PFO, associated with massive pulmonary embolism, with late presentation in our hospital and severe refractory right heart dysfunction. He underwent successful embolectomy, which is a unique procedure in the treatment of an acute pulmonary embolism and entrapped thrombus in a PFO. Conclusion The treatment of choice for emboli-in-transit is controversial. In a recent review, surgical thromboembolectomy showed a trend toward improved survival and significantly reduced systemic emboli compared to anticoagulation. Thrombolysis in these patients may cause fragmentation of thrombus and systemic embolization, resulting in increased mortality. Management decisions should be made with multidisciplinary coordination and consideration of complicating factors such as PFO. Abstract P689 Figure. Extensive biatrial thrombus

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