Document Detail

Right heart thrombus-in-transit with pulmonary embolism in a patient with primary hypercoagulable state.
MedLine Citation:
PMID:  20690100     Owner:  NLM     Status:  MEDLINE    
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.
Inas I Eweda; Sameh Samir; Osama Abbas; Ghada M El-Gohary; Wail Nammas
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Cardiology journal     Volume:  17     ISSN:  1897-5593     ISO Abbreviation:  Cardiol J     Publication Date:  2010  
Date Detail:
Created Date:  2010-08-06     Completed Date:  2010-11-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101392712     Medline TA:  Cardiol J     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  408-11     Citation Subset:  IM    
Cardiology Department, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, Egypt.
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MeSH Terms
Biological Markers / blood
Cardiopulmonary Bypass
DNA Mutational Analysis
Echocardiography, Transesophageal
Factor V / genetics
Heart Diseases / diagnosis,  etiology*,  surgery
Homocysteine / blood
Methylenetetrahydrofolate Reductase (NADPH2) / genetics
Middle Aged
Pulmonary Embolism / diagnosis,  etiology*,  surgery
Thrombophilia / blood,  complications*,  genetics
Thrombosis / diagnosis,  etiology*,  surgery
Tomography, X-Ray Computed
Treatment Outcome
Reg. No./Substance:
0/Biological Markers; 0/factor V Leiden; 454-28-4/Homocysteine; 9001-24-5/Factor V; EC Reductase (NADPH2)

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