Preview

Russian Journal of Cardiology

Advanced search

Right heart thrombosis in patients with pulmonary embolism: a case series

https://doi.org/10.15829/1560-4071-2024-5797

EDN: LSODEA

Abstract

Currently, recommendations have been developed for the treatment of patients with pulmonary embolism. However, the optimal management tactics for such patients in the presence of right heart thrombosis remains a matter of argument. Timely detection of right heart thrombosis can influence the choice of treatment tactics, which will help reduce the risk of adverse outcomes. The article presents three clinical cases with different clinical course options and management strategies that take into account risk factors and prognosis.

About the Authors

M. A. Teterina
ФГАОУ ВО Российский университет дружбы имени Патриса Лумумбы
Russian Federation


D. A. Ubaydullaeva
Peoples' Friendship University of Russia
Russian Federation

Moscow



N. A. Farzalieva
Peoples' Friendship University of Russia
Russian Federation

Moscow



A. R. Nazyrova
Peoples' Friendship University of Russia
Russian Federation

Moscow



M. G. Jayasinghe Havpage
Peoples' Friendship University of Russia
Russian Federation

Moscow



A. A. Lapshin
Peoples' Friendship University of Russia
Russian Federation

Moscow



I. Meray
Peoples' Friendship University of Russia
Russian Federation

Moscow



Zh. D. Kobalava
Peoples' Friendship University of Russia
Russian Federation

Moscow



References

1. De Divitiis M, Omran H, Rabahieh R, et al. Right atrial appendage thrombosis in atrial fibrillation: its frequency and its clinical predictors. Am J Cardiol. 1999;84(9):1023-8. doi:10.1016/s0002-9149(99)00492-0.

2. Khosla A, Mojibian H, Assi R, et al. Right heart thrombi (RHT) and clot in transit with concomitant PE management: Approach and considerations. Pulm. circ. 2022;12:е12080. doi:10.1002/pul2.12080.

3. Yilmaz M, Gurlertop Y, Erdogan F. Right atrial thrombus following closure of an atrial septal defect. Heart. 2003;89:726. doi:10.1136/heart.89.7.726.

4. Burns KE, McLaren A. Catheter-related right atrial thrombus and pulmonary embolism: a case report and systematic review of the literature. Can Respir J. 2009;16(5):163-5. doi:10.1155/2009/751507.

5. Konstantinides SV, Meyer G, Becattini C, et al.; ESC Scientific Document Group. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020;41(4):543-603. doi:10.1093/eurheartj/ehz405.

6. Koć M, Kostrubiec M, Elikowski W, et al.; RiHTER Investigators. Outcome of patients with right heart thrombi: the Right Heart Thrombi European Registry. Eur Respir J. 2016;47(3):869-75. doi:10.1183/13993003.00819-2015.

7. Muramoto H, Niwa A, Satoh Y, et al. Clinical Significance and Prognosis of Right Heart Thrombi Associated With Acute Pulmonary Thromboembolism — Results of a Multicenter Registry of Thrombolysis in Japan. Circ J. 2021;85(4):353-60. doi:10.1253/circj.CJ-20-0501.

8. Torbicki A, Galié N, Covezzoli A, et al.; ICOPER Study Group. Right heart thrombi in pulmonary embolism: results from the International Cooperative Pulmonary Embolism Registry. J Am Coll Cardiol. 2003;41(12):2245-51. doi:10.1016/s0735-1097(03)00479-0.

9. Barrios D, Rosa-Salazar V, Morillo R, et al. Prognostic Significance of Right Heart Thrombi in Patients With Acute Symptomatic Pulmonary Embolism: Systematic Review and Metaanalysis. Chest. 2017;151(2):409-16. doi:10.1016/j.chest.2016.09.038.

10. Barrios D, Rosa-Salazar V, Jiménez D, et al.; RIETE investigators. Right heart thrombi in pulmonary embolism. Eur Respir J. 2016;48(5):1377-85. doi:10.1183/13993003.01044-2016.

11. Sjoland H, Lindgren M, Toska T, et al. Pulmonary embolism and deep venous thrombosis after COVID-19: long-term risk in a population-based cohort study. Res Pract Thromb Haemost. 2023;7(5):100284. doi:10.1016/j.rpth.2023.100284.

12. Shah B, Ahmad MN, Khalid M, et al. Long COVID and Wavering Incidence of Pulmonary Embolism: A Systematic Review. J Community Hosp Intern Med Perspect. 2023; 13(5):23-31. doi:10.55729/2000-9666.1233.

13. Koc M, Kostrubiec M, Meneveau N, et al. Right heart thrombi European registry. Journal of the American College of Cardiology. 2015;65:A1553. doi:10.1016/S0735-1097(15)61553-4.

14. Athappan G, Sengodan P, Chacko P, et al. Comparative efficacy of different modalities for treatment of right heart thrombi in transit: a pooled analysis. Vasc Med. 2015;20(2): 131-8. doi:10.1177/1358863X15569009.

15. Burgos LM, Costabel JP, Galizia Brito V, et al. Floating right heart thrombi: A pooled analysis of cases reported over the past 10 years. Am J Emerg Med. 2018;36(6):911-5. doi:10.1016/j.ajem.2017.10.045.

16. Götzinger F, Lauder L, Sharp ASP, et al. Interventional therapies for pulmonary embolism. Nat Rev Cardiol. 2023;20(10):670-84. doi:10.1038/s41569-023-00876-0.

17. Goh FQ, Leow AS, Ho JS, et al. Clinical characteristics, treatment and long-term outcomes of patients with right-sided cardiac thrombus. Hellenic J Cardiol. 2022;68:1-8. doi:10.1016/j.hjc.2022.07.008.


Supplementary files

  • Timely detection of right heart thrombosis in pati­ents with pulmonary embolism may affect the choice of optimal treatment tactics and reduce the risk of adverse outcomes.
  • The presented cases demonstrate various clinical course options and patient management strategies that take into account risk factors and prognosis.

Review

For citations:


Teterina M.A., Ubaydullaeva D.A., Farzalieva N.A., Nazyrova A.R., Jayasinghe Havpage M.G., Lapshin A.A., Meray I., Kobalava Zh.D. Right heart thrombosis in patients with pulmonary embolism: a case series. Russian Journal of Cardiology. 2024;29(2S):5797. (In Russ.) https://doi.org/10.15829/1560-4071-2024-5797. EDN: LSODEA

Views: 1143


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1560-4071 (Print)
ISSN 2618-7620 (Online)