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European Heart Journal 1992 13(12):1724-1725;
Copyright © 1992 by the European Society of Cardiology.
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© 1992 The European Society of Cardiology

Right atrial thrombus migration during echocardiography: a case for urgent intervention

R. SENIOR, R. COWELL, P. THOMAS and E. B. RAFTERY

Northwick Park Hospital and Clinical Research Centre Watford Road, Harrow Middlesex HA1 3UJ, U.K.

Received 5 November 1991; revised 19 March 1992; .

Correspondence. Dr E. B. Raftery, Department of Cardiology, Northwick Park Hospital, Watford Road, Harrow, Middlesex HA1 3UJ, U K.

Abstract

A 65-year-old woman presented with increasing shortness of breath, chest pain and ST-T wave abnormalities on the electrocardiogram suggestive of unstable angina. Cross-sectional echocardiography performed to assess wall-motion abnormality and left ventricular function revealed a pedunculated right atrial thrombus prolapsing into the right ventricle which suddenly dislodged and migrated into the pulmonary circulation during the examination. A diagnosis of recurrent pulmonary thromboebolism was made, necessitating urgent pulmonary angiography with infusion of streptokinase. The patient made an uneventful recovery.

Key Words: Cross-sectional echocardiography • right atrial thrombus • pulmonary embolism


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