RIGHT ATRIAL THROMBI IN DEEP VEIN THROMBOSIS PATIENT WITH PULMONARY EMBOLISM

Song Giang Trần, Hữu Tuyển Nguyễn

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Abstract

Right heart thrombi is a rare condition with a high mortality rate. Currently, there is no optimal treatment protocol due to a lack of large-scale clinical trials. In this article, we describe a clinical case of right atrial thrombosis in a high-risk patient due to advanced age, large thrombus size, strong mobility, and a history of pulmonary embolism complications. Diagnosis was based on echocardiography and contrast-enhanced cardiac magnetic resonance imaging. Conventional treatment options including surgery, thrombus evacuation, and medical treatment with anticoagulant therapy were discussed. Results showed a gradual reduction and resolution of the right atrial thrombus following treatment with anticoagulant therapy.

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References

1. Rose PS, Punjabi NM, Pearse DB. Treatment of right heart thromboemboli. Chest. 2002; 121(3):806–14.
2. Ferrari E, Benhamou M, Berthier F, et al. Mobile thrombi of the right heart in pulmonary embolism: Delayed disappearance after thrombolytic therapy. Chest. 2005;121:1051–3.
3. Kearon C, Akl EA, Ornelas J, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest. 2016;149(2):315–52
4. Koc M, Kostrubiec M, Elikowski W, et al. The Right Heart Thrombi European Registry. Eur Respir J. 2016;47(3):869–75.
5. Anderson FA and Spencer FA, Risk factors for venous thromboembolism. Circulation, 2003. 107: p. I9 -I16.
6. Keijzer MBAJ, den Heijer M, and Blom HJ, nteraction between hyperhomocysteinemia, mutated methylenetetrahydrofolatereductase (MTHFR) and inherited thrombophilic factor in recurrent venous thrombosis. Thromb Haemost, 2002. 88: p. 723.
7. Dilley A, Austin H, and Hooper WC, Prevalence of the prothrombin 20210 G-to-A variant in blacks: Infants, patients with venous thrombosis, patients with myocardial infarction, and control subjects. J Lab Clin Med, 1998. 132: p. 452.
8. Kronik G. The European cooperative study on the clinical significance of right heart thrombi. Eur Heart J. 1989;10(12):1046–59.
9. Tsang BKT, Platts DG, Javorsky G, Brown MR.. Right ventricular thrombus detection and multimodality imaging using contrast echocardiography and cardiac magnetic resonance imaging. Heart Lung Circ 2012;21:185–188.
10. Barbagallo M, Naef D, Köpfli P, Hufschmid U, Niemann T, Gebker R, Beer JH, Hireche-Chiakoui H. Right ventricular thrombus, a challenge in imaging diagnostics: a case series. Eur Heart J Case Rep. 2021 Aug 25;5(9).