A Rare Case of a Right Atrial Thrombus

Right heart thrombi are a rare entity and are most often a result of deep vein thrombosis or structural heart disease. Right heart thrombi are frequently associated with pulmonary emboli and are often undiagnosed, leading to significant morbidity and mortality. The use of bedside ultrasound has made it far easier to identify these right heart thrombi or clots in transit. Early identification leads to early management and also aids the clinician in distinguishing the presentation from the many other causes of chest pain and shortness of breath. The authors present a case of a right atrial thrombus in an immunocompromised adult male patient. In this case report, the authors describe the investigations that led to the rapid identification of the right heart thrombus. Therapeutic options traditionally include surgical embolectomy, thrombolysis, anticoagulation, and percutaneous retrieval techniques. The authors were based in a resource-limited setting and will discuss the decision-making process that ensued.