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Venous thromboembolic disease presenting as inferior vena cava thrombus extending into the right atrium

Anand Khurana1, Tahir Tak

  • 1Department of Internal Medicine, Marshfield Clinic, Marshfield, Wisconsin, USA.

Clinical Medicine & Research
|June 3, 2005
PubMed

Insights

A rare case highlights inferior vena cava thrombus mimicking an intracardiac mass. This thrombus extended into the right atrium, leading to a pulmonary embolism that the patient survived.

Area of Science:

  • Cardiology
  • Diagnostic Imaging

Background:

  • Echocardiography, particularly transesophageal echocardiography, is increasingly utilized for diagnosing intracardiac masses.
  • Common intracardiac masses include atrial thrombi (often from atrial fibrillation), cardiac myxomas, and infective endocarditis vegetations.

Observation:

  • A case report details a patient with a thrombus originating in the inferior vena cava that extended into the right atrium.
  • This inferior vena cava thrombus was initially visualized and diagnosed as an apparent intracardiac mass.

Findings:

  • The inferior vena cava thrombus embolized to the right pulmonary artery shortly after diagnosis.
  • This embolization resulted in a pulmonary embolism.

Implications:

  • This case underscores the importance of considering thrombi from adjacent venous structures when diagnosing apparent intracardiac masses.
  • Accurate diagnosis and timely management are crucial for patients presenting with complex intracardiac or venous thrombi to prevent life-threatening complications like pulmonary embolism.

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