open access

Vol 17, No 4 (2010)
Case Reports
Published online: 2010-07-27
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Right heart thrombus-in-transit with pulmonary embolism in a patient with primary hypercoagulable state

Inas I. Eweda, Sameh Samir, Osama Abbas, Ghada M. El-Gohary, Wail Nammas
Cardiol J 2010;17(4):408-411.

open access

Vol 17, No 4 (2010)
Case Reports
Published online: 2010-07-27

Abstract

A 25 year-old female with a history of Caesarian section ten weeks ago presented with symptoms suggestive of pulmonary embolism. Transthoracic echocardiography revealed a free- -floating large thrombus traversing the right atrial cavity. Transesophageal echocardiography confirmed the presence of an unattached thrombus that originated from the most proximal part of the inferior vena cava. Multi-slice computed tomography of the chest and abdomen revealed the thrombus to start from the intra-hepatic part of the inferior vena cava and extend through the right atrium. It also demonstrated multiple thrombi in the pulmonary vasculature, the largest being in the right main pulmonary artery and its lower lobe branch. The patient was triaged for surgical embolectomy under cardio-pulmonary bypass. Follow-up trans-thoracic and transesophageal echocardiography confirmed adequate removal of the thrombus. By genetic examination, she proved to have factor V ’Leiden’ gene and two thrombophilia genes, all of which were positive in the heterozygous state. She had also a high serum homocysteine.
(Cardiol J 2010; 17, 4: 408-411)

Abstract

A 25 year-old female with a history of Caesarian section ten weeks ago presented with symptoms suggestive of pulmonary embolism. Transthoracic echocardiography revealed a free- -floating large thrombus traversing the right atrial cavity. Transesophageal echocardiography confirmed the presence of an unattached thrombus that originated from the most proximal part of the inferior vena cava. Multi-slice computed tomography of the chest and abdomen revealed the thrombus to start from the intra-hepatic part of the inferior vena cava and extend through the right atrium. It also demonstrated multiple thrombi in the pulmonary vasculature, the largest being in the right main pulmonary artery and its lower lobe branch. The patient was triaged for surgical embolectomy under cardio-pulmonary bypass. Follow-up trans-thoracic and transesophageal echocardiography confirmed adequate removal of the thrombus. By genetic examination, she proved to have factor V ’Leiden’ gene and two thrombophilia genes, all of which were positive in the heterozygous state. She had also a high serum homocysteine.
(Cardiol J 2010; 17, 4: 408-411)
Get Citation

Keywords

thrombus-in-transit; pulmonary embolism; hypercoagulable state

About this article
Title

Right heart thrombus-in-transit with pulmonary embolism in a patient with primary hypercoagulable state

Journal

Cardiology Journal

Issue

Vol 17, No 4 (2010)

Pages

408-411

Published online

2010-07-27

Bibliographic record

Cardiol J 2010;17(4):408-411.

Keywords

thrombus-in-transit
pulmonary embolism
hypercoagulable state

Authors

Inas I. Eweda
Sameh Samir
Osama Abbas
Ghada M. El-Gohary
Wail Nammas

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