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Published on: December 23, 2014
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Right heart thrombus in transit and peripherally inserted central catheters
Rezwan N Hussain1, Amit K J Mandal2, Nick Li1,3
1Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK.
Thrombosis Journal
|June 22, 2023
Summary
Right heart thrombus in transit, a medical emergency, can arise from deep vein thrombosis linked to central venous catheters. Early imaging and optimized catheter procedures are crucial for managing this life-threatening condition.
Area of Science:
- Cardiology
- Vascular Medicine
- Medical Imaging
Background:
- Right heart thrombus in transit (free-floating right heart thrombus) is a critical condition originating from deep vein thrombosis, often leading to pulmonary embolism.
- This condition carries a high mortality rate, exceeding 40%.
Purpose of the Study:
- To present two cases of right heart thrombus in transit with pulmonary thromboembolism.
- To highlight the association with peripherally inserted central catheters (PICCs).
- To discuss different management approaches and underscore preventative strategies.
Main Methods:
- Case report of two patients with right heart thrombus in transit and pulmonary thromboembolism.
- Utilized imaging modalities including computerised tomography and transthoracic echocardiography.
- Reviewed management strategies and procedural factors related to PICC lines.
Main Results:
- Both cases involved venous thrombosis associated with peripherally inserted central catheters.
- Different management approaches were employed for the two cases.
- The study emphasizes the importance of prompt diagnosis and intervention.
Conclusions:
- Clinicians should maintain a high index of suspicion for right heart thrombus in transit in patients with PICCs experiencing physiological changes.
- Utilizing imaging promptly is essential for diagnosis.
- Optimizing PICC insertion techniques and lumen selection can mitigate risks.
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