Images in Clinical Medicine
Massive Right Atrial Thrombus
N Engl J Med 2002; 347:e4October 3, 2002
- Article
Video
Echocardiographic Study Showing a Right Atrial Mass.
Figure 1 An 80-year-old woman presented to the emergency department soon after the onset of shortness of breath. Computed tomography of the chest (Panel A) revealed a pulmonary embolism and an apparent atrial mass. Subsequent transesophageal echocardiography (Panel B and video) demonstrated a large, mobile, right atrial mass that was tortuous in appearance and intermittently traversed the tricuspid valve. The patient was taken to the operating room, where a median sternotomy was performed and cardiopulmonary bypass was instituted. A firm, fibrotic thrombus that was 22 cm long was at the entrance to the right atrium. It contained a knot and obstructed nearly the entire atrium. The clot was extracted, and a separate pulmonary-artery thrombectomy was performed. On the following day, a Greenfield venacaval filter was placed and warfarin therapy was subsequently initiated. The patient was well one year after surgery. She had no previous history of atrial fibrillation.
Nick Dobrilovic, M.D.
Creighton B. Wright, M.D.
Jewish Hospital, Cincinnati, OH 45236- Citing Articles (1)
Citing Articles
1
Todd W Rice. (2006) Treatment of severe sepsis: where next? Current and future treatment approaches after the introduction of drotrecogin alfa. Vascular Health and Risk Management 2:1, 3-18
CrossRef
