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Visual Diagnosis in Emergency Medicine| Volume 48, ISSUE 4, e105-e108, April 2015

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Right Heart Thrombus in Transit Diagnosed by Bedside Ultrasound

  • Joanne S. Martires
    Affiliations
    Division of Pulmonary and Critical Care Medicine, Department of Medicine, UCLA-Olive View Medical Center, UCLA Geffen School of Medicine, Sylmar, California
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  • Susan J. Stein
    Affiliations
    Division of Pulmonary and Critical Care Medicine, Department of Medicine, UCLA-Olive View Medical Center, UCLA Geffen School of Medicine, Sylmar, California
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  • Nader Kamangar
    Correspondence
    Reprint Address: Nader Kamangar, md, facp, fccp, fccm, Division of Pulmonary and Critical Care Medicine, Department of Medicine, UCLA-Olive View Medical Center, David Geffen School of Medicine at UCLA, 14445 Olive View Drive, Room 2B-182, Sylmar, CA 91342
    Affiliations
    Division of Pulmonary and Critical Care Medicine, Department of Medicine, UCLA-Olive View Medical Center, UCLA Geffen School of Medicine, Sylmar, California
    Search for articles by this author
      Right heart thrombi in transit represent deep venous thrombi that have mobilized and become lodged in the right heart en route to the pulmonary arteries, with the potential to migrate and lead to additional embolic complications. Due to their increased risk for mortality, right heart thrombi in transit represent a severe form of venous thromboembolism. In addition, in patients with patent foramen ovale (PFO) or atrial septal defect (ASD), right heart thrombi in transit can lead to systemic thromboembolism. Once diagnosed, right heart thrombi in transit require consideration of emergent treatment such as thrombolytics, surgical thromboembolectomy, or catheter-based intervention, due to the potential of the clot to fragment or migrate leading to further vascular obstruction and hemodynamic compromise.
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