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Right heart thrombus causing syncope in an elderly patient.

Eva D Papadimitraki1, Dimitrios Papadopoulos1, Kanella Zerva1

  • 1Department of Cardiology, Laiko General Hospital, Athens, Greece.

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|July 30, 2015
PubMed
Summary

A dehydrated elderly patient with syncope had high-risk pulmonary embolism and a right heart thrombus. Echocardiography revealed thrombi, guiding life-saving treatment for this frail patient.

Keywords:
older peoplepulmonary embolism in elderlyright heart thrombussyncopethrombolysis

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Area of Science:

  • Cardiology
  • Vascular Medicine
  • Geriatrics

Background:

  • Pulmonary embolism (PE) and thromboembolic disease are associated with significant mortality.
  • Timely recognition and management are crucial for improving patient outcomes.

Observation:

  • An elderly female patient presented with recurrent syncope and dehydration.
  • Echocardiography revealed a free-floating right heart thrombus.
  • Possible "in transit" thrombi were observed in a low-flow inferior vena cava.

Findings:

  • The patient was diagnosed with high-risk pulmonary embolism.
  • Echocardiographic findings were instrumental in guiding treatment decisions.
  • The identified right heart thrombus and IVC thrombi posed a significant risk.

Implications:

  • This case highlights the importance of echocardiography in diagnosing complex thromboembolic events in elderly patients.
  • Prompt identification and management of right heart thrombi and PE can be life-saving.
  • The findings underscore the need for tailored treatment strategies in frail, elderly individuals with cardiovascular emergencies.