Extensive biatrial thrombus straddling the patent foramen ovale and traversing into the left and right ventricle.

Autor:	Sattar A; Department of Internal Medicine, Division of Cardiology, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA., Win TT; Department of Internal Medicine, Division of Cardiology, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA., Schevchuck A; Department of Internal Medicine, Division of Cardiology, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA., Achrekar A; Department of Internal Medicine, Division of Cardiology, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.
Jazyk:	angličtina
Zdroj:	BMJ case reports [BMJ Case Rep] 2016 Nov 21; Vol. 2016. Date of Electronic Publication: 2016 Nov 21.
DOI:	10.1136/bcr-2016-216761
Abstrakt:	We report an extremely rare case of an extensive biatrial thrombus straddling a patent foramen ovale (PFO) extending into the bilateral ventricles in a patient presenting with an acute embolic stroke. Our patient further developed a massive saddle pulmonary embolus (PE) with haemodynamic instability during the course of his hospitalisation. The risks of pharmacological thrombolysis or surgical thrombectomy for PE in a haemodynamically unstable patient with recent embolic stroke posed a significant therapeutic dilemma. Ultimately, the decision was made to continue anticoagulation with unfractionated heparin followed by oral Coumadin. The patient responded well to therapy and at 1-month follow-up, a complete resolution of the thrombus was documented on transoesophageal echocardiogram with full clinical recovery of the patient. Competing Interests: Conflicts of Interest: None declared. (2016 BMJ Publishing Group Ltd.)
Databáze:	MEDLINE
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