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Updated: Aug 8, 2026
06:29
Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
Mobile right heart thrombus and massive pulmonary embolism
Evelyn A de Vrey1, Jeroen J Bax, Don Poldermans
1Cardiology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands. e.a.de_vrey@lumc.nl
Summary
A patient with pulmonary embolism and right heart thrombus, unresponsive to heparin, underwent successful surgical embolectomy. This intervention resolved symptoms, highlighting the critical nature of mobile right heart thrombus.
Area of Science:
- Cardiology
- Vascular Surgery
Background:
- Pulmonary embolism (PE) is a significant cause of morbidity and mortality.
- Heparin is a standard anticoagulant for PE, but treatment can be unsuccessful.
Observation:
- A patient presented with PE refractory to heparin therapy.
- Transthoracic echocardiography identified a mobile thrombus in the right heart.
- Transesophageal echocardiography traced the thrombus origin to the inferior vena cava.
Findings:
- Mobile right heart thrombus carries a high mortality rate exceeding 40%.
- Surgical embolectomy was performed urgently.
- The patient experienced symptom relief post-surgery.
Implications:
- Urgent surgical intervention is crucial for mobile right heart thrombus.
- Echocardiography plays a vital role in diagnosing and locating cardiac thrombi.
- This case underscores the importance of considering surgical options in complex PE cases.
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