Ebato Mio, Kitai Hitomi, Kumakura Hideko, Nakamura Yoshiko, Shimizu Nobuyuki, Takeyama Youichi
Division of Clinicopathology, Showa University Fujigaoka Hospital, Yokohama, Japan.
Circ J. 2002 Apr;66(4):425-7. doi: 10.1253/circj.66.425.
A 62-year-old woman with a history of pulmonary embolism and primary antiphospholipid syndrome (PAPS) with positivity for lupus anticoagulant was admitted to hospital with shortness of breath. A filter had been implanted in her inferior vena cava (IVC) 5 years previously. Emergency echocardiography revealed a lobulated, mobile echogenic mass on the tricuspid valve, and on pulmonary perfusion scintigraphy several apparently new defects were noted. Fibrinolytic therapy improved her symptoms and the pulmonary perfusion, then intravenous heparinization was continued for a further week. Repeat echocardiography performed on the 7th day of the admission showed complete disappearance of the mass, which was retrospectively diagnosed as a thrombus based on its resolution with fibrinolytic and anticoagulant therapies.
