Article Text

Download PDFPDF
Peeking at the right heart at the right moment: a giant thrombus in transit
  1. Miguel Lourenço Varela1,
  2. Teresa Mota2,
  3. Rita Martins Fernandes3,
  4. Francisco Soto1
  1. 1 Intensive Care Medicine 1, Hospital de Faro, Faro, Portugal
  2. 2 Cardiology, Hospital de Faro, Faro, Portugal
  3. 3 Internal Medicine, Hospital de Faro, Faro, Portugal
  1. Correspondence to Dr Miguel Lourenço Varela, Intensive Care Medicine 1, Hospital de Faro, Faro 8000-386, Portugal; miguelnvarela{at}gmail.com

Statistics from Altmetric.com

A 46-year-old man, with acute-on-chronic hepatic failure and dilated cardiomyopathy, was admitted in the intermediate care unit after a sudden episode of dyspnoea without hypotension but with an elevated lactate of 3.9 mmol/L. He had an international normalised ratio of 3 and decreased factor V of 32.9%.

A bedside echocardiogram, while on sinus rhythm, revealed a mobile right atrial mass (figure 1A,B; see videos in supplementary material). Both ventricles were dilated with severely depressed function. No thrombi were present in a previous examination, 3 days before.

Supplementary video

[postgradmedj-2019-137027supp001.wmv]

Supplementary video

[postgradmedj-2019-137027supp002.wmv]

Figure 1

A highly mobile heterogeneous hyperechoic …

View Full Text

Footnotes

  • Contributors MLV and TM performed the echocardiogram; MLV wrote the first draft; RMF, TM and FS revised the article and added content to it.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.