open access

Vol 12, No 1 (2017)
Original Papers
Published online: 2017-03-03
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Assessment of the clinical course of patients with acute pulmonary embolism and right heart thrombi — a single centre experience

Marcin Koć, Barbara Lichodziejewska, Katarzyna Kurnicka, Maciej Kostrubiec, Michał Ciurzyński, Marzanna Paczyńska, Sylwia Goliszek, Anna Wyzgał, Krzysztof Jankowski, Katarzyna Grudzka, Szymon Pacho, Marcin Krupa, Anna Lipińska, Piotr Palczewski, Piotr Pruszczyk
DOI: 10.5603/FC.2017.0001
·
Folia Cardiologica 2017;12(1):1-7.

open access

Vol 12, No 1 (2017)
Original Papers
Published online: 2017-03-03

Abstract

Introduction. Assessment of the clinical course of patients with acute pulmonary embolism (PE) and a right heart thrombus (RiHT).

Material and methods. The analysis included 13 consecutive patients with echocardiographically detected RiHT and acute PE who were treated in our department. The endpoints were 30-day all-cause mortality and 30-day acute PE-related mortality. When a clear alternative cause of death was reported, a non-acute PE-related death was diagnosed and this contributed to 30-day all-cause mortality. All other fatalities were classified as related to acute PE.

Results. High risk acute PE was diagnosed in 4 of 13 patients, and intermediate risk acute PE was diagnosed in the remaining 9 patients. Thrombolysis was the first-choice treatment in 4 (31%) patients, 6 (46%) patients were only anticoagulated, and the remaining 3 (23%) patients underwent surgical treatment. The main indication for embolectomy was RiHT entrapped in a patent foramen ovale (PFO). Two patients died during the first 30 days; they were hemodynamically unstable and deaths occurred within 48 hours since the diagnosis. No hemodynamically stable patients died within 30 days since the diagnosis.

Conclusions. Thirty-day mortality in patients with RiHT depended mostly on the patient’s clinical condition and was not related to the presence or morphology of the thrombus. Patients with shock or hypotension may possibly benefit more from primary invasive treatment compared to drug therapy.

Abstract

Introduction. Assessment of the clinical course of patients with acute pulmonary embolism (PE) and a right heart thrombus (RiHT).

Material and methods. The analysis included 13 consecutive patients with echocardiographically detected RiHT and acute PE who were treated in our department. The endpoints were 30-day all-cause mortality and 30-day acute PE-related mortality. When a clear alternative cause of death was reported, a non-acute PE-related death was diagnosed and this contributed to 30-day all-cause mortality. All other fatalities were classified as related to acute PE.

Results. High risk acute PE was diagnosed in 4 of 13 patients, and intermediate risk acute PE was diagnosed in the remaining 9 patients. Thrombolysis was the first-choice treatment in 4 (31%) patients, 6 (46%) patients were only anticoagulated, and the remaining 3 (23%) patients underwent surgical treatment. The main indication for embolectomy was RiHT entrapped in a patent foramen ovale (PFO). Two patients died during the first 30 days; they were hemodynamically unstable and deaths occurred within 48 hours since the diagnosis. No hemodynamically stable patients died within 30 days since the diagnosis.

Conclusions. Thirty-day mortality in patients with RiHT depended mostly on the patient’s clinical condition and was not related to the presence or morphology of the thrombus. Patients with shock or hypotension may possibly benefit more from primary invasive treatment compared to drug therapy.

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Keywords

pulmonary embolism, right heart thrombus, prognosis

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About this article
Title

Assessment of the clinical course of patients with acute pulmonary embolism and right heart thrombi — a single centre experience

Journal

Folia Cardiologica

Issue

Vol 12, No 1 (2017)

Pages

1-7

Published online

2017-03-03

DOI

10.5603/FC.2017.0001

Bibliographic record

Folia Cardiologica 2017;12(1):1-7.

Keywords

pulmonary embolism
right heart thrombus
prognosis

Authors

Marcin Koć
Barbara Lichodziejewska
Katarzyna Kurnicka
Maciej Kostrubiec
Michał Ciurzyński
Marzanna Paczyńska
Sylwia Goliszek
Anna Wyzgał
Krzysztof Jankowski
Katarzyna Grudzka
Szymon Pacho
Marcin Krupa
Anna Lipińska
Piotr Palczewski
Piotr Pruszczyk

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