The dilemma in the management of haemodynamically stable pulmonary embolism with right heart thrombus. Issue 7 (23rd July 2019)

• Record Type: Journal Article
• Authors: Rai, Manoj P; Herzallah, Khadar; Alratroot, Ahmad; Laird-Fick, Heather
• Is Part Of: BMJ case reports. Volume 12:Issue 7(2019)
• Publication Date: 2019-07-23
• Subjects: venous thromboembolism -- interventional cardiology -- haematology (incl blood transfusion); Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2018-229162
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Right ventricular thrombus (RVT) can be life-threatening, since it has the potential to embolise and cause saddle pulmonary embolism (PE). We present a patient who initially presented with haemodynamically stable PE with evidence of RVT on echocardiogram. She was placed on heparin drip; however, she later developed cardiac arrest and died due to embolisation of RVT to the pulmonary vasculature. Although management of haemodynamically stable PE in patients with RVT is still a matter of debate, 1 given the outcome we suggest that thrombolysis or emergent embolectomy at the presentation, in this case, may have had a favourable outcome.