Anticoagulation therapy for pulmonary embolism involving a myxoma mimicking, giant type C thrombus: A case report

Yinhe Feng; Yubin Wang; Xiaolong Li; Hui Mao

doi:10.7555/JBR.36.20220118

Volume 37 Issue 2

Mar. 2023

Turn off MathJax

Article Contents

Article Navigation > The Journal of Biomedical Research > 2023 > 37(2): 148-152

Yinhe Feng, Yubin Wang, Xiaolong Li, Hui Mao. Anticoagulation therapy for pulmonary embolism involving a myxoma mimicking, giant type C thrombus: A case report[J]. The Journal of Biomedical Research, 2023, 37(2): 148-152. doi: 10.7555/JBR.36.20220118

Citation:

Yinhe Feng, Yubin Wang, Xiaolong Li, Hui Mao. Anticoagulation therapy for pulmonary embolism involving a myxoma mimicking, giant type C thrombus: A case report[J]. The Journal of Biomedical Research, 2023, 37(2): 148-152. doi: 10.7555/JBR.36.20220118

Citation:

PDF( 9773 KB)

Anticoagulation therapy for pulmonary embolism involving a myxoma mimicking, giant type C thrombus: A case report

doi: 10.7555/JBR.36.20220118

Yinhe Feng^{1, 2},
Yubin Wang²,
Xiaolong Li¹,
Hui Mao^{2
,
,}

1.
Department of Respiratory and Critical Care Medicine, People's Hospital of Deyang City, Affiliated Hospital of Chengdu College of Medicine, Deyang, Sichuan 618000, China
2.
Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China

More Information

Corresponding author: Hui Mao, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, #37 Guoxue Alley, Chengdu, Sichuan 610041, China. Tel/Fax: +86-28-85423061/+86-28-85582994, E-mail: merrymh@yeah.net
Received: 2022-05-18
Revised: 2022-06-08
Accepted: 2022-06-16

Published: 2022-07-28

Issue Date: 2023-03-28

Abstract

Abstract

Right heart thrombus (RHTh) with concurrent acute pulmonary embolism (PE) is rare and can seriously destabilize hemodynamics, leading to an emergency situation with high mortality. Diagnosis and treatment of RHTh with acute PE are not yet standardized. There are few reports of acute PE concurrent with RHTh and even less is known about patients with a right heart mural thrombus. For physicians, the diagnostic choice and treatment of these patients are particularly difficult due to the lack of knowledge. Here, we report a rare case of partial mural RHTh (type C RHTh) with acute PE. The mural mass in the right heart was initially diagnosed as atrial myxoma according to transthoracic echocardiography (TTE), and both pulmonary embolus and the mural mass were completely absorbed after administering Rivaroxiban. This case suggests that TTE alone is insufficient to identify and diagnoses a right heart mural mass such as this. However, novel oral anticoagulants may be effective at alleviating PE with type C RHTh.
- pulmonary embolism,
- intracardiac thrombus,
- atrial myxoma,
- anticoagulant

CLC number: R563.5, Document code: B
The authors reported no conflict of interests.

FullText(HTML)

References(14)

References

[1]	Raskob GE, Angchaisuksiri P, Blanco AN, et al. Thrombosis: A major contributor to global disease burden[J]. Thromb Res, 2014, 134(5): 931–938. doi: 10.1016/j.thromres.2014.08.014
[2]	Wendelboe AM, Raskob GE. Global burden of thrombosis: epidemiologic aspects[J]. Circ Res, 2016, 118(9): 1340–1347. doi: 10.1161/CIRCRESAHA.115.306841
[3]	Jenab Y, Ariannejad H, Rabbani Z, et al. Pulmonary embolism and right heart thrombi: a single-center experience[J]. J Tehran Heart Cent, 2021, 16(1): 26–30. doi: 10.18502/jthc.v16i1.6597
[4]	Nkoke C, Faucher O, Camus L, et al. Free floating right heart thrombus associated with acute pulmonary embolism: an unsettled therapeutic difficulty[J]. Case Rep Cardiol, 2015, 2015: 364780. doi: 10.1155/2015/364780
[5]	Konstantinides SV, Barco S, Lankeit M, et al. Management of pulmonary embolism: an update[J]. J Am Coll Cardiol, 2016, 67(8): 976–990. doi: 10.1016/j.jacc.2015.11.061
[6]	Hayıroğlu Mİ, Bozbeyoğlu E, Akyüz Ş, et al. Acute myocardial infarction with concomitant pulmonary embolism as a result of patent foramen ovale[J]. Am J Emerg Med, 2015, 33(7): 984.e5–984.e7. doi: 10.1016/j.ajem.2014.12.025
[7]	Ozturk C, Dumantepe M. Successful treatment of right heart thrombus and high-risk pulmonary embolism with acoustic pulse thrombolysis using EKOS endovascular system[J]. J Card Surg, 2021, 36(8): 2961–2964. doi: 10.1111/jocs.15593
[8]	Kalivoda EJ, Rodriguez KR, Cabrera G. Right heart thrombus in transit diagnosed with focused cardiac ultrasound in the emergency department[J]. Cureus, 2020, 12(7): e9354. doi: 10.7759/cureus.9354
[9]	Barbagallo M, Naef D, Köpfli P, et al. Right ventricular thrombus, a challenge in imaging diagnostics: a case series[J]. Eur Heart J Case Rep, 2021, 5(9): ytab340. doi: 10.1093/ehjcr/ytab340
[10]	Mumoli N, Cei M, Pasquinelli P, et al. Floating heart metastasis[J]. J Am Soc Echocardiogr, 2006, 19(10): 1293.e1–1293.e2. doi: 10.1016/j.echo.2006.05.014
[11]	Cinar T, Hayiroğlu Mİ, Çiçek V, et al. Predictors of left atrial thrombus in acute ischemic stroke patients without atrial fibrillation: a single-center cross-sectional study[J]. Rev Assoc Med Bras (1992), 2020, 66(10): 1437–1443. doi: 10.1590/1806-9282.66.10.1437
[12]	Burgos LM, Costabel JP, Brito VG, et al. Floating right heart thrombi: A pooled analysis of cases reported over the past 10 years[J]. Am J Emerg Med, 2018, 36(6): 911–915. doi: 10.1016/j.ajem.2017.10.045
[13]	Rai MP, Herzallah K, Alratroot A, et al. The dilemma in the management of haemodynamically stable pulmonary embolism with right heart thrombus[J]. BMJ Case Rep, 2019, 12(7): e229162. doi: 10.1136/bcr-2018-229162
[14]	Kaya A, Hayıroğlu Mİ, Keskin M, et al. Resolution of left ventricular thrombus with apixaban in a patient with hypertrophic cardiomyopathy[J]. Turk Kardiyol Dern Ars, 2016, 44(4): 335–337. doi: 10.5543/tkda.2015.68054