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Related Experiment Video

Updated: Sep 24, 2025

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Right heart thrombi (RHT) and clot in transit with concomitant PE management: Approach and considerations.

Akhil Khosla1, Hamid Mojibian2, Roland Assi3

  • 1Department of Internal Medicine, Section of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine Yale New Haven Hospital New-Haven Connecticut USA.

Pulmonary Circulation
|May 6, 2022
PubMed
Summary

Right heart thrombi (RHT) with pulmonary embolism (PE) increases poor outcomes. This review covers RHT management, risk stratification, and treatment considerations for complex cases.

Keywords:
pulmonary embolism (PE)right heart thrombi (RHT)thrombectomythrombolytic therapy

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Area of Science:

  • Cardiology
  • Pulmonology
  • Vascular Medicine

Background:

  • Right heart thrombi (RHT) pose a significant clinical challenge, particularly when co-occurring with pulmonary embolism (PE).
  • Patients with concomitant PE and RHT face a higher risk of adverse outcomes compared to those with PE alone.
  • The incidence of RHT is not well-established, but point-of-care ultrasound may increase its detection.

Purpose of the Study:

  • To review the current understanding of right heart thrombi in the context of pulmonary embolism.
  • To discuss risk stratification, treatment options, and management strategies for RHT with PE.

Main Methods:

  • Literature review focusing on RHT and PE.
  • Analysis of existing treatment modalities including anticoagulation, thrombolysis, and surgical options.

Main Results:

  • RHT in PE patients is associated with increased morbidity and mortality.
  • Management strategies are diverse, involving multiple medical specialties.
  • Limited clinical data and guidelines currently exist for RHT management.

Conclusions:

  • Effective management of RHT with PE requires a multidisciplinary approach.
  • Further research and clear guidelines are needed to optimize patient care.
  • This review provides a framework for risk stratification and treatment considerations.