| Thrombolysis for saddle pulmonary embolism and 3-chamber thrombus. | |
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MedLine Citation:
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PMID: 20401303 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Currently, the only widely accepted indication for thrombolysis in cases of pulmonary embolism is hemodynamic instability. However, the presence of a right-heart thrombus along with pulmonary embolism is a poor prognostic indicator, and the use of thrombolytic agents should also be considered in this circumstance. Furthermore, despite a risk of distal embolization, thrombolytic therapy may be implemented if the intracardiac thrombus also straddles a patent foramen ovale. Herein, we present the case of a 92-year-old woman who presented at our institution after a syncopal event and multiple recent episodes of amaurosis fugax. Transthoracic echocardiography revealed a mobile right-heart thrombus that extended through a patent foramen ovale into the left atrium. Computed tomography of the chest showed a saddle pulmonary embolus. We used thrombolytic therapy to treat the patient, and imaging showed complete resolution of the thrombus and the embolism 2 days later. |
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Authors:
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Tariq Salman; Sameer Satija; Stephanie F Martin; Laurence Sperling |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital Volume: 37 ISSN: 1526-6702 ISO Abbreviation: Tex Heart Inst J Publication Date: 2010 |
Date Detail:
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Created Date: 2010-04-19 Completed Date: 2010-07-26 Revised Date: 2010-09-30 |
Medline Journal Info:
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Nlm Unique ID: 8214622 Medline TA: Tex Heart Inst J Country: United States |
Other Details:
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Languages: eng Pagination: 234-6 Citation Subset: IM |
Affiliation:
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J. Willis Hurst Internal Medicine Residency Program, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia 30303, USA. tsalman@emory.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged, 80 and over Coronary Disease / complications, diagnosis, therapy* Echocardiography Female Foramen Ovale, Patent / complications Humans Pulmonary Embolism / complications, diagnosis, therapy* Thrombolytic Therapy* Thrombosis / complications, diagnosis, therapy* Tomography, X-Ray Computed Treatment Outcome |
| Comments/Corrections | |
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