Morphology of right heart thrombi in pulmonary embolism: A case series and analysis

• Main Authors: Nisamudeen Kajamohideen, N Swaminathan, G Palanisamy, G Gnanavelu, Venkatesan Sangareddi
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2017-01-01
• Series: Journal of the Indian Academy of Echocardiography & Cardiovascular Imaging
• Subjects: echocardiography; outcomes; right heart thrombi; treatment; thrombi types
• Online Access: http://www.jiaecho.org/article.asp?issn=2543-1463;year=2017;volume=1;issue=1;spage=24;epage=26;aulast=Kajamohideen

Introduction: The occurrence of right heart thrombus (RiHT) in pulmonary embolism (PE) carries poor prognosis. Type A Thrombi are serpiginous, highly mobile with high mortality. Type B Thrombi are less mobile and have better prognosis. Type C is intermediate in all characteristics. Methods: This is an observational study done in patients presenting with RiHT with PE to the emergency unit of our institute from March to August 2016. A total of seven patient's clinical and electrocardiographic data were collected with a history of deep vein thrombosis or hypercoagulability. Results: This case series of seven patients with right heart thrombi in pulmonary embolism showed a predominance of male patients, with right ventricle dysfunction and pulmonary hypertension in all cases. Conclusion: Early fibrinolysis in type A thrombus had a favourable outcome. Mortality was 29% in our series.