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Thrombolysis for saddle pulmonary embolism and 3-chamber thrombus.

ABSTRACT: 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.

SUBMITTER: Salman T

PROVIDER: S-EPMC2851412 | biostudies-literature | 2010

REPOSITORIES: biostudies-literature

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Thrombolysis for saddle pulmonary embolism and 3-chamber thrombus.

Salman Tariq T Satija Sameer S Martin Stephanie F SF Sperling Laurence L

Texas Heart Institute journal 20100101 2

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 c ...[more]

PMID: 20401303

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