Right cardiac thrombus in transit among patients with pulmonary thromboemboli

This study was designed to investigate the prevalence, clinical and laboratory findings, and short-term prognostic significance of mobile right cardiac thrombus (MRCT) among patients with pulmonary thromboembolism (PTE).

From January 2004 to November 2006, 12 of 100 patients admitted with a diagnosis of PTE had an MRCT. Diagnosis of in-transit right-sided thrombi was made when a wormlike elongated mass was detected. The primary end point was comparison of the mortality rate of MRCT (+) patients with that of MRCT (-) patients for an average of 8 months of follow-up. The secondary end points were comparison of clinical and laboratory data between these 2 groups.

All MRCT (+) patients but 1 had dyspnea, but just 2 patients had syncope during exertion. The most frequent electrocardiographic finding was T inversion in leads V1-V3 (75%). All 6 of the MRCT (+) patients who had a cardiac arrest in the hospital died in the hospital. In comparison, of the 88 MRCT (-) patients, 12 had a cardiorespiratory arrest, 4 of whom survived (hospital mortality rate of 50% versus 9%, respectively).

It seems that the presence of MRCT has prognostic significance, predicting a higher-than-average mortality rate.