Successful treatment of mobile right atrial thrombus and acute pulmonary embolism with intravenous tissue plasminogen activator
UMass Chan Affiliations
Department of Internal Medicine, Division of CardiologyDocument Type
Journal ArticlePublication Date
2013-07-25Keywords
Acute DiseaseAged, 80 and over
Female
Fibrinolytic Agents
Heart Atria
Humans
Infusions, Intravenous
Pulmonary Embolism
Thrombosis
Tissue Plasminogen Activator
Cardiology
Cardiovascular Diseases
Metadata
Show full item recordAbstract
An 89-year-old woman came with symptoms of progressively worsening dyspnoea at rest over the preceding week. She was normotensive, had elevated jugular venous pressure and clear lungs. ECG revealed atrial fibrillation with the rapid ventricular rate. Labs were significant for markedly elevated pro-brain natriuretic peptide of 43,000 pg/mL and troponin-T of 1 ng/mL. An urgent 2D echocardiogram was obtained, which revealed the severely dilated right atrium and a large linear mobile mass in the right atrium consistent with a thrombus. An emergent CT scan revealed multiple bilateral pulmonary emboli. She received intravenous tissue plasminogen activator. Repeat echocardiogram performed 6 h later showed no evidence of the right atrial thrombus. She was subsequently maintained on intravenous heparin and transitioned to Coumadin. Early recognition of this rare but potentially fatal complication is important as prompt treatment measures can help in preventing life-threatening complications of the right atrial thrombus.Source
BMJ Case Rep. 2013 Jul 25;2013. pii: bcr2013010255. doi: 10.1136/bcr-2013-010255. Link to article on publisher's siteDOI
10.1136/bcr-2013-010255Permanent Link to this Item
http://hdl.handle.net/20.500.14038/30224PubMed ID
23892824Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1136/bcr-2013-010255