[Two-dimensional and Doppler echocardiographic findings of a sudden death case due to multiple pulmonary thromboses]

This is a case report presenting interesting findings on two-dimensional and Doppler echocardiograms due to multiple pulmonary thromboses. A 67-year-old woman had a history of surgery for colon polyps in August, 1986. After surgery, she suffered from tachycardia and dyspnea, and was admitted to our hospital because of a loss of consciousness. Sinus tachycardia, complete right bundle branch block and T-wave inversion in leads III, aVF and V1-4 were observed on her electrocardiogram. Cardiomegaly was noted on her chest radiograph. On the third hospital day, echocardiography was performed. On two-dimensional echocardiography, marked right ventricular dilatation with hypokinesis of the wall, and a flattened interventricular septum were observed on the short-axis view, and M-mode echocardiograms showed disappearance of the E wave and delay of the opening of the tricuspid valve, resulting in a monophasic triangular pattern. Doppler echocardiography showed the tricuspid valve flow to be delayed, mainly observed during atrial systole. These findings indicate decreased right ventricular compliance. The patient died on the 6th hospital day, and multiple new and old thrombi were found in the pulmonary artery at autopsy.