Detection of right atrial thrombus in a woman with pulmonary embolism and right heart compromise by bedside echocardiography
A 59-year-old female with a history of stage IV lung adenocarcinoma presented with worsening shortness of breath and cough over several weeks. She was tachycardic, hypotensive, and tachypneic. Portable chest x-ray suggested bilateral pleural effusions and computed tomography angiography (CTA) reveal...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-01-01
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| Series: | Respiratory Medicine Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213007122001666 |
| _version_ | 1828173961470410752 |
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| author | M. Johnkutty K. Gada S. Ahmad |
| author_facet | M. Johnkutty K. Gada S. Ahmad |
| author_sort | M. Johnkutty |
| collection | DOAJ |
| description | A 59-year-old female with a history of stage IV lung adenocarcinoma presented with worsening shortness of breath and cough over several weeks. She was tachycardic, hypotensive, and tachypneic. Portable chest x-ray suggested bilateral pleural effusions and computed tomography angiography (CTA) revealed bilateral pulmonary emboli (PE) with suspected right heart strain. Upon admission to the medical intensive care unit for treatment of PE, bedside echocardiography was performed to direct management. Indicators of cor pulmonale and right heart strain were apparent including right ventricle dilation, reduced tricuspid systolic excursion, and a deformed left ventricle with “D sign”. Most notably, a right atrial thrombus was detected, a finding not initially seen on CTA. Ultimately, prompt detection of the effects on the right ventricle by bedside echocardiography directed the next step in this patient's clinical course without delay. |
| first_indexed | 2024-04-12T04:04:01Z |
| format | Article |
| id | doaj.art-5cdd544ee8324a0b868857ea6d9e0d93 |
| institution | Directory Open Access Journal |
| issn | 2213-0071 |
| language | English |
| last_indexed | 2024-04-12T04:04:01Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Respiratory Medicine Case Reports |
| spelling | doaj.art-5cdd544ee8324a0b868857ea6d9e0d932022-12-22T03:48:39ZengElsevierRespiratory Medicine Case Reports2213-00712022-01-0140101744Detection of right atrial thrombus in a woman with pulmonary embolism and right heart compromise by bedside echocardiographyM. Johnkutty0K. Gada1S. Ahmad2Renaissance School of Medicine, Stony Brook University, United StatesDivision of Pulmonary Medicine, Department of Medicine, Stony Brook University Hospital, United States; Corresponding author. Division of Pulmonary Medicine, 101 Nicolls Rd, Stony Brook, NY, 11790, United States .Division of Pulmonary Medicine, Department of Medicine, Stony Brook University Hospital, United StatesA 59-year-old female with a history of stage IV lung adenocarcinoma presented with worsening shortness of breath and cough over several weeks. She was tachycardic, hypotensive, and tachypneic. Portable chest x-ray suggested bilateral pleural effusions and computed tomography angiography (CTA) revealed bilateral pulmonary emboli (PE) with suspected right heart strain. Upon admission to the medical intensive care unit for treatment of PE, bedside echocardiography was performed to direct management. Indicators of cor pulmonale and right heart strain were apparent including right ventricle dilation, reduced tricuspid systolic excursion, and a deformed left ventricle with “D sign”. Most notably, a right atrial thrombus was detected, a finding not initially seen on CTA. Ultimately, prompt detection of the effects on the right ventricle by bedside echocardiography directed the next step in this patient's clinical course without delay.http://www.sciencedirect.com/science/article/pii/S2213007122001666ThrombusPulmonary embolismRight ventricular failureUltrasound |
| spellingShingle | M. Johnkutty K. Gada S. Ahmad Detection of right atrial thrombus in a woman with pulmonary embolism and right heart compromise by bedside echocardiography Respiratory Medicine Case Reports Thrombus Pulmonary embolism Right ventricular failure Ultrasound |
| title | Detection of right atrial thrombus in a woman with pulmonary embolism and right heart compromise by bedside echocardiography |
| title_full | Detection of right atrial thrombus in a woman with pulmonary embolism and right heart compromise by bedside echocardiography |
| title_fullStr | Detection of right atrial thrombus in a woman with pulmonary embolism and right heart compromise by bedside echocardiography |
| title_full_unstemmed | Detection of right atrial thrombus in a woman with pulmonary embolism and right heart compromise by bedside echocardiography |
| title_short | Detection of right atrial thrombus in a woman with pulmonary embolism and right heart compromise by bedside echocardiography |
| title_sort | detection of right atrial thrombus in a woman with pulmonary embolism and right heart compromise by bedside echocardiography |
| topic | Thrombus Pulmonary embolism Right ventricular failure Ultrasound |
| url | http://www.sciencedirect.com/science/article/pii/S2213007122001666 |
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