Related Experiment Video
Updated: Jul 3, 2026
09:22
Chronic Thromboembolic Pulmonary Hypertension and Assessment of Right Ventricular Function in the Piglet
Published on: November 4, 2015
Free floating thrombus in the right atrium causing massive pulmonary embolism
International Journal of Cardiology
|August 6, 2008
Summary
Massive pulmonary embolism can arise from lower limb thrombi. A rare case of right atrial free-floating thrombus causing massive pulmonary embolism was successfully treated with tenecteplase.
Area of Science:
- Cardiology
- Vascular Medicine
- Critical Care Medicine
Background:
- Lower limb deep vein thrombosis (DVT) can lead to pulmonary embolism (PE), a life-threatening condition.
- Massive PE accounts for 30% of cases with a high mortality rate (around 50%).
- Free-floating thrombi in cardiac cavities are uncommon, posing diagnostic and therapeutic challenges.
Observation:
- An 80-year-old patient presented with massive pulmonary embolism.
- Echocardiography revealed a rare free-floating thrombus within the right atrium.
- The patient had no prior history of venous thromboembolism.
Findings:
- The massive pulmonary embolism was attributed to the right atrial free-floating thrombus.
- Tenecteplase, a thrombolytic agent, was administered for treatment.
- The patient showed an excellent response to tenecteplase therapy.
Implications:
- This case highlights the importance of considering cardiac thrombi in massive PE, even without typical DVT.
- Successful thrombolysis with tenecteplase offers a potential therapeutic option for this rare condition.
- Early diagnosis and prompt treatment are crucial for improving outcomes in massive PE due to cardiac thrombi.
Related Concept Videos
01:29Pulmonary Embolism I: Introduction
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
01:19Pulmonary Embolism I: Introduction
A blood clot, or thrombus, is a semi-solid mass composed of fibrin, platelets, and red blood cells. When it forms within a vessel, it can obstruct blood flow, known as thrombosis. If part of the clot detaches, it becomes an embolus that can travel and block distant vessels. When this occurs in the pulmonary arteries, it causes a condition known as pulmonary embolism (PE).Origin and ImpactMost often, the embolus originates from a thrombus in the deep veins of the lower limbs, a condition called...
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
01:30Venous Thrombosis I: Introduction
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
01:27Pulmonary Embolism III: Nursing Management
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
01:21Cardiac Catheterization II: Right Heart Catheterization
Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...