Charif Fida, Mansour Mohamad Jihad, Hamdan Righab, Najjar Claudette, Nassar Pierre, Issa Mohamad, Chammas Elie, Saab Mohamad
Lebanese University, Faculty of Medical Sciences, Hadath, Lebanon.
Division of Pulmonary Medicine, Beirut Cardiac Institute, Beirut, Lebanon.
J Cardiovasc Echogr. 2018 Apr-Jun;28(2):146-149. doi: 10.4103/jcecho.jcecho_64_17.
Free-floating right heart thrombus (RHT) is an extreme medical emergency in the context of acute massive pulmonary embolism (PE). Despite the advances in early diagnosis, the management is still very debatable due to lack of consensus. We reported the case of a 66-year-old male, with a history of moderate renal dysfunction and dilated cardiomyopathy, who presented to the emergency department for acute dyspnea. His angiographic magnetic resonance imaging revealed bilateral extensive PE. Transthoracic echocardiography showed RHT with moderate right ventricular dysfunction and pulmonary hypertension. Venous Doppler of the lower extremities noted the presence of a floating clot in the right common femoral vein. The patient was managed successfully by thrombolytic therapy with tenecteplase. To the best of our knowledge, this is the first case report of RHT and PE from Lebanon. Published cases from Middle Eastern countries are scarse.
在急性大面积肺栓塞（PE）的情况下，游离性右心血栓（RHT）是一种极其危急的医疗状况。尽管早期诊断取得了进展，但由于缺乏共识，治疗方法仍存在很大争议。我们报告了一例66岁男性病例，该患者有中度肾功能不全和扩张型心肌病病史，因急性呼吸困难就诊于急诊科。他的血管造影磁共振成像显示双侧广泛肺栓塞。经胸超声心动图显示右心血栓伴中度右心室功能障碍和肺动脉高压。下肢静脉多普勒检查发现右股总静脉存在漂浮血栓。该患者通过替奈普酶溶栓治疗成功治愈。据我们所知，这是黎巴嫩首例关于右心血栓和肺栓塞的病例报告。中东国家已发表的病例很少。
