Rai Manoj P, Herzallah Khadar, Alratroot Ahmad, Laird-Fick Heather
Internal Medicine, Michigan State University, Lansing, Michigan, USA.
BMJ Case Rep. 2019 Jul 23;12(7):e229162. doi: 10.1136/bcr-2018-229162.
Right ventricular thrombus (RVT) can be life-threatening, since it has the potential to embolise and cause saddle pulmonary embolism (PE). We present a patient who initially presented with haemodynamically stable PE with evidence of RVT on echocardiogram. She was placed on heparin drip; however, she later developed cardiac arrest and died due to embolisation of RVT to the pulmonary vasculature. Although management of haemodynamically stable PE in patients with RVT is still a matter of debate, given the outcome we suggest that thrombolysis or emergent embolectomy at the presentation, in this case, may have had a favourable outcome.
右心室血栓（RVT）可能危及生命，因为它有可能发生栓塞并导致马鞍形肺栓塞（PE）。我们报告一名患者，最初表现为血流动力学稳定的肺栓塞，超声心动图显示有右心室血栓的证据。她接受了肝素静脉滴注治疗；然而，她后来发生心脏骤停，因右心室血栓栓塞至肺血管而死亡。尽管对于血流动力学稳定的右心室血栓患者的肺栓塞管理仍存在争议，但鉴于此结果，我们认为在本例中，就诊时进行溶栓或紧急栓子切除术可能会有较好的结果。
