Document Detail


Thrombolysis for saddle pulmonary embolism and 3-chamber thrombus.
MedLine Citation:
PMID:  20401303     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Tariq Salman; Sameer Satija; Stephanie F Martin; Laurence Sperling
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
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:
Created Date:  2010-04-19     Completed Date:  2010-07-26     Revised Date:  2010-09-30    
Medline Journal Info:
Nlm Unique ID:  8214622     Medline TA:  Tex Heart Inst J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  234-6     Citation Subset:  IM    
Affiliation:
J. Willis Hurst Internal Medicine Residency Program, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia 30303, USA. tsalman@emory.edu
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MeSH Terms
Descriptor/Qualifier:
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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