Indian Journal of Medical Research

CLINICAL IMAGES
Year
: 2017  |  Volume : 145  |  Issue : 4  |  Page : 575-

Freely moving right ventricular thrombus in a patient with acute pulmonary embolism


Kunal Mahajan, Prakash Chand Negi 
 Department of Cardiology, Indira Gandhi Medical College & Hospital, Shimla 171 001, Himachal Pradesh, India

Correspondence Address:
Prakash Chand Negi
Department of Cardiology, Indira Gandhi Medical College & Hospital, Shimla 171 001, Himachal Pradesh
India




How to cite this article:
Mahajan K, Negi PC. Freely moving right ventricular thrombus in a patient with acute pulmonary embolism.Indian J Med Res 2017;145:575-575


How to cite this URL:
Mahajan K, Negi PC. Freely moving right ventricular thrombus in a patient with acute pulmonary embolism. Indian J Med Res [serial online] 2017 [cited 2020 Jan 18 ];145:575-575
Available from: http://www.ijmr.org.in/text.asp?2017/145/4/575/213749


Full Text



A 28 yr old female patient presented to the department of Cardiology, Indira Gandhi Medical College, Shimla, India, in December 2015, with complaints of sudden onset dyspnoea of two days duration. There was no chest pain, cough or fever. Patient had been using oral contraceptives for the past five months. She was having tachycardia (114 bpm) and a blood pressure of 126/80 mmHg. Chest and cardiovascular examination was unremarkable. Electrocardiogram revealed sinus tachycardia. Serum D-dimer was elevated. She was subjected to computerized pulmonary angiography which showed a thrombus in right pulmonary artery ([Figure 1]A, arrow). Echocardiography showed normal right ventricular function but demonstrated a highly mobile-free floating thrombus in the right ventricular cavity ([Figure 1]B and [Video 1]). Cardiac magnetic resonance imaging (MRI) confirmed it to be a free-floating thrombus and ruled out tumour [Figure 1]C. Duplex scan of lower limbs ruled out deep venous thrombosis. Since patient was haemodynamically stable and had normal right ventricle function, she was treated with low molecular weight heparin and warfarin. There was complete dissolution of thrombus in three week time [Figure 1]D. Detailed workup for the genetic and acquired causes of thrombophilia was negative except for the history of oral contraceptive use. Careful evaluation is warranted for better identification.{Figure 1}[MULTIMEDIA:1]