Right heart thrombi (RHT) and clot in transit with concomitant PE management: Approach and considerations
Abstract Right heart thrombi (RHT) continues to pose a clinical dilemma for multiple specialties and is especially concerning when present with concomitant pulmonary embolism (PE). Patients with PE and RHT are at an increased risk of poor outcomes compared to PE without RHT. Although the exact incid...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-04-01
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| Series: | Pulmonary Circulation |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/pul2.12080 |
| _version_ | 1827871683196747776 |
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| author | Akhil Khosla Hamid Mojibian Roland Assi Hossam Tantawy Inderjit Singh Jeffrey Pollak |
| author_facet | Akhil Khosla Hamid Mojibian Roland Assi Hossam Tantawy Inderjit Singh Jeffrey Pollak |
| author_sort | Akhil Khosla |
| collection | DOAJ |
| description | Abstract Right heart thrombi (RHT) continues to pose a clinical dilemma for multiple specialties and is especially concerning when present with concomitant pulmonary embolism (PE). Patients with PE and RHT are at an increased risk of poor outcomes compared to PE without RHT. Although the exact incidence of RHT is unknown, the increasing use of point‐of‐care ultrasound may lead to an increased detection and frequency of RHT. There are multiple treatment strategies available for RHT, including anticoagulation, systemic thrombolysis, and endovascular and surgical therapies. Given that these treatment strategies involve multiple medical specialties, the management of RHT with concomitant PE can be complex. Currently, there is limited clinical data and guidelines on the treatment and management of RHT. We aim to provide a review on RHT with concomitant PE, including risk stratification, treatment considerations, and our approach to the management of RHT. |
| first_indexed | 2024-03-12T16:13:20Z |
| format | Article |
| id | doaj.art-4f18283e955c4ecfbd1f8bd169177e19 |
| institution | Directory Open Access Journal |
| issn | 2045-8940 |
| language | English |
| last_indexed | 2024-03-12T16:13:20Z |
| publishDate | 2022-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pulmonary Circulation |
| spelling | doaj.art-4f18283e955c4ecfbd1f8bd169177e192023-08-09T10:21:08ZengWileyPulmonary Circulation2045-89402022-04-01122n/an/a10.1002/pul2.12080Right heart thrombi (RHT) and clot in transit with concomitant PE management: Approach and considerationsAkhil Khosla0Hamid Mojibian1Roland Assi2Hossam Tantawy3Inderjit Singh4Jeffrey Pollak5Department of Internal Medicine, Section of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine Yale New Haven Hospital New‐Haven Connecticut USADepartment of Radiology and Biomedical Imaging, Section of Vascular and Interventional Radiology Yale University School of Medicine New Haven Connecticut USADivision of Cardiac Surgery Yale University School of Medicine New Haven Connecticut USADepartment of Anesthesiology Yale University School of Medicine New Haven Connecticut USADepartment of Internal Medicine, Section of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine Yale New Haven Hospital New‐Haven Connecticut USADepartment of Radiology and Biomedical Imaging, Section of Vascular and Interventional Radiology Yale University School of Medicine New Haven Connecticut USAAbstract Right heart thrombi (RHT) continues to pose a clinical dilemma for multiple specialties and is especially concerning when present with concomitant pulmonary embolism (PE). Patients with PE and RHT are at an increased risk of poor outcomes compared to PE without RHT. Although the exact incidence of RHT is unknown, the increasing use of point‐of‐care ultrasound may lead to an increased detection and frequency of RHT. There are multiple treatment strategies available for RHT, including anticoagulation, systemic thrombolysis, and endovascular and surgical therapies. Given that these treatment strategies involve multiple medical specialties, the management of RHT with concomitant PE can be complex. Currently, there is limited clinical data and guidelines on the treatment and management of RHT. We aim to provide a review on RHT with concomitant PE, including risk stratification, treatment considerations, and our approach to the management of RHT.https://doi.org/10.1002/pul2.12080pulmonary embolism (PE)right heart thrombi (RHT)thrombectomythrombolytic therapy |
| spellingShingle | Akhil Khosla Hamid Mojibian Roland Assi Hossam Tantawy Inderjit Singh Jeffrey Pollak Right heart thrombi (RHT) and clot in transit with concomitant PE management: Approach and considerations Pulmonary Circulation pulmonary embolism (PE) right heart thrombi (RHT) thrombectomy thrombolytic therapy |
| title | Right heart thrombi (RHT) and clot in transit with concomitant PE management: Approach and considerations |
| title_full | Right heart thrombi (RHT) and clot in transit with concomitant PE management: Approach and considerations |
| title_fullStr | Right heart thrombi (RHT) and clot in transit with concomitant PE management: Approach and considerations |
| title_full_unstemmed | Right heart thrombi (RHT) and clot in transit with concomitant PE management: Approach and considerations |
| title_short | Right heart thrombi (RHT) and clot in transit with concomitant PE management: Approach and considerations |
| title_sort | right heart thrombi rht and clot in transit with concomitant pe management approach and considerations |
| topic | pulmonary embolism (PE) right heart thrombi (RHT) thrombectomy thrombolytic therapy |
| url | https://doi.org/10.1002/pul2.12080 |
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