Presentation
SLE. Echo shows ? thrombus adherent to CVC.
Patient Data
Perma-Cath passes through the SVC, right atrium and tricuspid valve to enter the right ventricle with the tip directed towards the ventricular apex. There is circumferential low-density material surrounding the catheter in the SVC which represents an adherent thrombus. Within the right ventricle, there is a 20 x 12 mm low-density structure, closely related to the catheter and right ventricular wall with several radiating linear densities. This suggests right ventricular thrombus adherent to papillary muscle hyperplasia with surrounding thickened chordae tendineae.
There is a partially occlusive pulmonary embolus in the distal left main pulmonary artery, left descending pulmonary artery and further pulmonary embolus in the posterior segmental branch of the right lower lobe pulmonary artery.
Case Discussion
The patient was treated with thrombolysis and monitored with serial echocardiograms.
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