Right Heart Thrombus in-Transit in Patient with Acute Pulmonary Embolism Treated by Thrombolytic Therapy with Tenectplase

Warkaa Al Shamkhani; Nagham Saeed Jafar; Sunil Roy Narayanan; Krishna Ramanagaram Gowda; Anil Kumar Rajappan

doi:doi:10.11648/j.ijmi.20150302.11

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Right Heart Thrombus in-Transit in Patient with Acute Pulmonary Embolism Treated by Thrombolytic Therapy with Tenectplase

Warkaa Al Shamkhani, Nagham Saeed Jafar, Sunil Roy Narayanan, Krishna Ramanagaram Gowda, Anil Kumar Rajappan

Published in International Journal of Medical Imaging (Volume 3, Issue 2)

Received: 30 January 2015 Accepted: 13 February 2015 Published: 2 March 2015

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Abstract

A thrombus in transit is an uncommon life threatening condition with high morbidity and mortality. Thrombectomy, thrombolytic therapy and anticoagulation are the treatment options in patients with acute pulmonary embolism and thrombus in transit. A 30-year old male presented with acute submassive pulmonary embolism. Echocardiography showed features of acute pulmonary embolism with right ventricular dysfunction and large fresh mobile thrombus in the right ventricular cavity. He was treated by thrombolytic therapy with Tenecteplase. He made an uneventful recovery with normalisation of the ECG, CXR and Echocardiography on subsequent follow up. This case demonstrates the efficacy of thrombolytic therapy in patients with right ventricular thrombus in transit.

Published in	International Journal of Medical Imaging (Volume 3, Issue 2)
DOI	10.11648/j.ijmi.20150302.11
Page(s)	11-15
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Thrombus in Transit, Thrombolytic Therapy, Pulmonary Embolism

References

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[2]	Redberg RF, Hecht SR, Berger M. Echocardiographic detection of transient right heart thrombus: now you see it, now you don’t. Am Heart J 1991; 122: 862-4.
[3]	Chartier L, Bera J, Delomez M et al. Free- floating thrombi in the right heart: diagnosis, management, and prognostic indexes in 38 consecutive patients. Circulation 1999; 99: 2779-93.
[4]	Rose PS, Punjabi NM, Pearse DB. Treatment of right heart thromboemboli. Chest 2002; 121: 806-14.
[5]	Golhaber SZ, Visani L, De Rosa M. Acute Pulmonary Embolism: Clinical Outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet 1999; 353:1386-9.
[6]	Livaditis IG, Paraschos M, Dimopoulos K. Massive pulmonary embolism with ST elevation in leads V1-V3 and successful thrombolysis with Tenecteplase Heart 2004; 90: e41.
[7]	Kline JA, Nordenholz KE, Courtney DM et al. Treatment of submassive pulmonary embolism with Tenecteplase or placebo: cardiopulmonary outcomes at 3 months: Multicenter double-blind, placebo controlled randomized trial. J Thromb Haemost 2014; 12: 459-68.
[8]	Patra S, Nagesh CM, Reddy B et al Thrombolysis with single bolus Tenecteplase compared with Streptokinase infusion in the treatment of acute pulmonary embolism: A pilot study. Clin Appl Thromb Hemost 2013.
[9]	Steering Committee. Single-bolus Tenecteplase plus heparin compared with heparin alone for normotensive patients with acute pulmonary embolism who have evidence of right ventricular dysfunction and myocardial injury: rationale and design of the Pulmonary Embolism Thrombolysis (PEITHO) trial. Am Heart J 2012; 163: 33-38.
[10]	Babu K, Krishnan MN, Vinayakumar D et al. A floating right heart thrombus in transit across tricuspid valve causing an endocardial friction rub. Indian Heart J 2013; 65: 457-9.
[11]	Hisatomi K, Yamada T, Onohara D. Surgical embolectomy of a floating right heart thrombus and acute massive pulmonary embolism: report of a case. Ann Thorac Cardiovasc Surg 2013; 19: 316-9.
[12]	Richartz BM, Werner GS, Ferrari M et al. Non-surgical extraction of right cardiac “thrombus in transit”. Catheter Cardiovasc Interv 200; 51: 316-9.

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APA Style

Warkaa Al Shamkhani, Nagham Saeed Jafar, Sunil Roy Narayanan, Krishna Ramanagaram Gowda, Anil Kumar Rajappan. (2015). Right Heart Thrombus in-Transit in Patient with Acute Pulmonary Embolism Treated by Thrombolytic Therapy with Tenectplase. International Journal of Medical Imaging, 3(2), 11-15. https://doi.org/10.11648/j.ijmi.20150302.11

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ACS Style

Warkaa Al Shamkhani; Nagham Saeed Jafar; Sunil Roy Narayanan; Krishna Ramanagaram Gowda; Anil Kumar Rajappan. Right Heart Thrombus in-Transit in Patient with Acute Pulmonary Embolism Treated by Thrombolytic Therapy with Tenectplase. Int. J. Med. Imaging 2015, 3(2), 11-15. doi: 10.11648/j.ijmi.20150302.11

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AMA Style

Warkaa Al Shamkhani, Nagham Saeed Jafar, Sunil Roy Narayanan, Krishna Ramanagaram Gowda, Anil Kumar Rajappan. Right Heart Thrombus in-Transit in Patient with Acute Pulmonary Embolism Treated by Thrombolytic Therapy with Tenectplase. Int J Med Imaging. 2015;3(2):11-15. doi: 10.11648/j.ijmi.20150302.11

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@article{10.11648/j.ijmi.20150302.11,
  author = {Warkaa Al Shamkhani and Nagham Saeed Jafar and Sunil Roy Narayanan and Krishna Ramanagaram Gowda and Anil Kumar Rajappan},
  title = {Right Heart Thrombus in-Transit in Patient with Acute Pulmonary Embolism Treated by Thrombolytic Therapy with Tenectplase},
  journal = {International Journal of Medical Imaging},
  volume = {3},
  number = {2},
  pages = {11-15},
  doi = {10.11648/j.ijmi.20150302.11},
  url = {https://doi.org/10.11648/j.ijmi.20150302.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20150302.11},
  abstract = {A thrombus in transit is an uncommon life threatening condition with high morbidity and mortality. Thrombectomy, thrombolytic therapy and anticoagulation are the treatment options in patients with acute pulmonary embolism and thrombus in transit. A 30-year old male presented with acute submassive pulmonary embolism. Echocardiography showed features of acute pulmonary embolism with right ventricular dysfunction and large fresh mobile thrombus in the right ventricular cavity. He was treated by thrombolytic therapy with Tenecteplase. He made an uneventful recovery with normalisation of the ECG, CXR and Echocardiography on subsequent follow up. This case demonstrates the efficacy of thrombolytic therapy in patients with right ventricular thrombus in transit.},
 year = {2015}
}

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TY  - JOUR
T1  - Right Heart Thrombus in-Transit in Patient with Acute Pulmonary Embolism Treated by Thrombolytic Therapy with Tenectplase
AU  - Warkaa Al Shamkhani
AU  - Nagham Saeed Jafar
AU  - Sunil Roy Narayanan
AU  - Krishna Ramanagaram Gowda
AU  - Anil Kumar Rajappan
Y1  - 2015/03/02
PY  - 2015
N1  - https://doi.org/10.11648/j.ijmi.20150302.11
DO  - 10.11648/j.ijmi.20150302.11
T2  - International Journal of Medical Imaging
JF  - International Journal of Medical Imaging
JO  - International Journal of Medical Imaging
SP  - 11
EP  - 15
PB  - Science Publishing Group
SN  - 2330-832X
UR  - https://doi.org/10.11648/j.ijmi.20150302.11
AB  - A thrombus in transit is an uncommon life threatening condition with high morbidity and mortality. Thrombectomy, thrombolytic therapy and anticoagulation are the treatment options in patients with acute pulmonary embolism and thrombus in transit. A 30-year old male presented with acute submassive pulmonary embolism. Echocardiography showed features of acute pulmonary embolism with right ventricular dysfunction and large fresh mobile thrombus in the right ventricular cavity. He was treated by thrombolytic therapy with Tenecteplase. He made an uneventful recovery with normalisation of the ECG, CXR and Echocardiography on subsequent follow up. This case demonstrates the efficacy of thrombolytic therapy in patients with right ventricular thrombus in transit.
VL  - 3
IS  - 2
ER  -

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Author Information

Warkaa Al Shamkhani

Department of Cardiology, Belhoul Speciality Hospital, Dubai, UAE
Nagham Saeed Jafar

Department of Cardiology, Belhoul Speciality Hospital, Dubai, UAE
Sunil Roy Narayanan

Department of Cardiology, Belhoul Speciality Hospital, Dubai, UAE
Krishna Ramanagaram Gowda

Department of Cardiology, Belhoul Speciality Hospital, Dubai, UAE
Anil Kumar Rajappan

Department of Cardiology, Belhoul Speciality Hospital, Dubai, UAE

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Plain Text BibTeX RIS

APA Style

Warkaa Al Shamkhani, Nagham Saeed Jafar, Sunil Roy Narayanan, Krishna Ramanagaram Gowda, Anil Kumar Rajappan. (2015). Right Heart Thrombus in-Transit in Patient with Acute Pulmonary Embolism Treated by Thrombolytic Therapy with Tenectplase. International Journal of Medical Imaging, 3(2), 11-15. https://doi.org/10.11648/j.ijmi.20150302.11

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ACS Style

Warkaa Al Shamkhani; Nagham Saeed Jafar; Sunil Roy Narayanan; Krishna Ramanagaram Gowda; Anil Kumar Rajappan. Right Heart Thrombus in-Transit in Patient with Acute Pulmonary Embolism Treated by Thrombolytic Therapy with Tenectplase. Int. J. Med. Imaging 2015, 3(2), 11-15. doi: 10.11648/j.ijmi.20150302.11

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AMA Style

Warkaa Al Shamkhani, Nagham Saeed Jafar, Sunil Roy Narayanan, Krishna Ramanagaram Gowda, Anil Kumar Rajappan. Right Heart Thrombus in-Transit in Patient with Acute Pulmonary Embolism Treated by Thrombolytic Therapy with Tenectplase. Int J Med Imaging. 2015;3(2):11-15. doi: 10.11648/j.ijmi.20150302.11

Copy | Download

@article{10.11648/j.ijmi.20150302.11,
  author = {Warkaa Al Shamkhani and Nagham Saeed Jafar and Sunil Roy Narayanan and Krishna Ramanagaram Gowda and Anil Kumar Rajappan},
  title = {Right Heart Thrombus in-Transit in Patient with Acute Pulmonary Embolism Treated by Thrombolytic Therapy with Tenectplase},
  journal = {International Journal of Medical Imaging},
  volume = {3},
  number = {2},
  pages = {11-15},
  doi = {10.11648/j.ijmi.20150302.11},
  url = {https://doi.org/10.11648/j.ijmi.20150302.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20150302.11},
  abstract = {A thrombus in transit is an uncommon life threatening condition with high morbidity and mortality. Thrombectomy, thrombolytic therapy and anticoagulation are the treatment options in patients with acute pulmonary embolism and thrombus in transit. A 30-year old male presented with acute submassive pulmonary embolism. Echocardiography showed features of acute pulmonary embolism with right ventricular dysfunction and large fresh mobile thrombus in the right ventricular cavity. He was treated by thrombolytic therapy with Tenecteplase. He made an uneventful recovery with normalisation of the ECG, CXR and Echocardiography on subsequent follow up. This case demonstrates the efficacy of thrombolytic therapy in patients with right ventricular thrombus in transit.},
 year = {2015}
}

Copy | Download

TY  - JOUR
T1  - Right Heart Thrombus in-Transit in Patient with Acute Pulmonary Embolism Treated by Thrombolytic Therapy with Tenectplase
AU  - Warkaa Al Shamkhani
AU  - Nagham Saeed Jafar
AU  - Sunil Roy Narayanan
AU  - Krishna Ramanagaram Gowda
AU  - Anil Kumar Rajappan
Y1  - 2015/03/02
PY  - 2015
N1  - https://doi.org/10.11648/j.ijmi.20150302.11
DO  - 10.11648/j.ijmi.20150302.11
T2  - International Journal of Medical Imaging
JF  - International Journal of Medical Imaging
JO  - International Journal of Medical Imaging
SP  - 11
EP  - 15
PB  - Science Publishing Group
SN  - 2330-832X
UR  - https://doi.org/10.11648/j.ijmi.20150302.11
AB  - A thrombus in transit is an uncommon life threatening condition with high morbidity and mortality. Thrombectomy, thrombolytic therapy and anticoagulation are the treatment options in patients with acute pulmonary embolism and thrombus in transit. A 30-year old male presented with acute submassive pulmonary embolism. Echocardiography showed features of acute pulmonary embolism with right ventricular dysfunction and large fresh mobile thrombus in the right ventricular cavity. He was treated by thrombolytic therapy with Tenecteplase. He made an uneventful recovery with normalisation of the ECG, CXR and Echocardiography on subsequent follow up. This case demonstrates the efficacy of thrombolytic therapy in patients with right ventricular thrombus in transit.
VL  - 3
IS  - 2
ER  -

Copy | Download