Wong Christopher Cy, Yiannikas John
Department of Cardiology, Concord Hospital, University of Sydney, Australia.
Eur J Case Rep Intern Med. 2020 May 1;7(8):001644. doi: 10.12890/2020_001644. eCollection 2020.
Right heart thrombus (RHT) is a medical condition associated with acute pulmonary embolism and congestive cardiac failure. Rapid recognition is essential for instituting early treatment and preventing adverse outcomes.
A 55-year-old male presented with symptoms of congestive cardiac failure complicated by cardiac arrest. Initial transthoracic echocardiography (TTE) demonstrated moderate impairment of both ventricles and a moderately dilated right ventricle (RV). After initial improvement with heart failure treatment, the patient subsequently had a second cardiac arrest. Bedside TTE revealed complete RV obstruction by thrombus, and intravenous thrombolysis was immediately instituted, with complete dissolution of the thrombus and haemodynamic recovery 15 minutes after treatment. Unfortunately, the patient suffered significant hypoxic brain injury and did not survive.
RHT can manifest acutely in a dramatic fashion with cardiac arrest. Bedside TTE is key to making a rapid diagnosis in this setting to allow early administration of thrombolytic therapy.
Right heart thrombus (RHT) may manifest acutely as cardiac arrest in patients with underlying cardiomyopathy.Echocardiography is essential for rapid diagnosis of RHT.Thrombolysis can lead to rapid thrombus dissolution and haemodynamic improvement.
右心血栓（RHT）是一种与急性肺栓塞和充血性心力衰竭相关的病症。快速识别对于尽早开展治疗及预防不良后果至关重要。
一名55岁男性患者出现充血性心力衰竭症状并并发心脏骤停。初始经胸超声心动图（TTE）显示双心室中度受损，右心室（RV）中度扩张。在心力衰竭治疗后病情初步改善后，患者随后再次发生心脏骤停。床旁TTE显示血栓完全阻塞右心室，随即立即进行静脉溶栓治疗，治疗15分钟后血栓完全溶解，血流动力学恢复。不幸的是，患者发生严重缺氧性脑损伤，最终死亡。
RHT可急性发作，表现为心脏骤停。在此情况下，床旁TTE是快速诊断的关键，以便尽早给予溶栓治疗。
右心血栓（RHT）在患有潜在心肌病的患者中可能急性发作表现为心脏骤停。超声心动图对于RHT的快速诊断至关重要。溶栓可导致血栓快速溶解和血流动力学改善。
