Presentation
Tachypnea. High oxygen requirement.
Patient Data
Extensive bilateral pulmonary emboli, extending from right and left main pulmonary arteries to the subsegmental levels.
Large cyclindrical free clot within the right atrium (50mm x 8mm).
Right ventricular strain with dilated main pulmonary artery and right heart chambers and reflux of contrast medium into a dilated IVC and hepatic veins.
Case Discussion
This is a case of intracardiac thrombus which was identified on transthoracic echocardiography and subsequently sent for CTPA to look for propagation of the thrombus into pulmonary arteries. This case demonstrates the importance of looking further than the pulmonary arteries in a CTPA study to look for a cause of the emboli, as well as the complications. The intracardiac thrombus has lead to circulatory failure, seen here as a dilated right cardiac system and inferior vena cava / hepatic veins.
Unable to process the form. Check for errors and try again.