[The echocardiographic demonstration of a right atrial thrombus and its embolization into the lung]

A 43-year-old man was hospitalized because of extensive bilateral pulmonary tuberculosis. After several weeks of tuberculostatic treatment--at first applied orally, then because of nausea and vomiting parenterally via a central venous catheter--he acutely developed nocturnal dyspnoea and symptoms of shock requiring artificial ventilation. Echocardiography demonstrated dilatation of the right ventricle and a large floating thrombus in the right atrium. During the examination complete displacement of the worm-like thrombus into the pulmonary artery was observed echocardiographically. Despite anticoagulation and immediate operation the patient died 2 days later of protracted shock. The thrombus was found to have been formed in the superior vena cava after placement of the central venous catheter.