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Case of Biatrial Thrombosis
Bülent Görenek1, Yüksel Çavuşoğglu, Bilgin Timuralp
1Sivrihisar Cad. 126/9 Sahin Apt., 26120 Eskisehir, Turkey.
Echocardiography (Mount Kisco, N.Y.)
|February 15, 2001
Summary
A patient with pulmonary embolism and atrial thrombi experienced rapid symptom relief after thrombolytic therapy was initiated and then stopped due to a transient speech disturbance. Echocardiography confirmed the resolution of both pulmonary embolism and atrial clots.
Area of Science:
- Cardiology
- Pulmonology
- Vascular Medicine
Background:
- Atrial thrombi can be associated with pulmonary embolism, posing significant clinical challenges.
- Dyspnea at rest can be a critical symptom indicating severe cardiopulmonary compromise.
- Echocardiography is a valuable bedside tool for diagnosing intracardiac thrombi and assessing cardiac function.
Purpose of the Study:
- To report a case of a patient presenting with dyspnea, atrial thrombi, and pulmonary embolism.
- To describe the clinical course and management of this complex presentation.
- To highlight the utility of echocardiography in monitoring thrombus resolution.
Main Methods:
- Bedside echocardiography for initial thrombus detection and follow-up.
- Lung perfusion scintigraphy for diagnosing pulmonary embolism.
- Intravenous thrombolytic therapy with recombinant tissue plasminogen activator.
Main Results:
- Initial echocardiography revealed multiple small thrombi in both the right and left atria.
- Lung perfusion scintigraphy confirmed pulmonary embolism.
- Following a partial dose of thrombolytic therapy, the patient experienced transient speech disturbance, leading to cessation of treatment. Subsequently, dyspnea resolved, and repeat echocardiography showed complete disappearance of atrial thrombi.
Conclusions:
- This case demonstrates the potential for spontaneous resolution of atrial thrombi and associated pulmonary embolism after cautious and limited thrombolytic intervention.
- Transient neurological events can occur during thrombolytic therapy, necessitating careful monitoring and prompt discontinuation if adverse effects arise.
- Bedside echocardiography is crucial for real-time assessment of thrombus burden and response to treatment in patients with complex thromboembolic disease.