Cardiology Department, Hospital Garcia de Orta EPE, Almada, Portugal.
Cardiology Department, Hospital Garcia de Orta EPE, Almada, Portugal
BMJ Case Rep. 2022 May 11;15(5):e249225. doi: 10.1136/bcr-2022-249225.
We present a woman in her 60s diagnosed with an intermediate-high risk acute pulmonary embolism and a large, non-serpiginous right atrial (RA) mass. Conservative therapy with unfractionated heparin was started and further assessment of the mass with cardiac MRI suggested thrombus as the most likely diagnosis. Despite 1 month of anticoagulation, mass size remained stable and surgical RA embolectomy and left pulmonary endarterectomy was performed. Histopathology confirmed thrombus. The patient died 10 weeks after surgery.
我们报告了一位 60 多岁的女性患者，诊断为中高危急性肺栓塞和巨大、非匐行性右心房（RA）肿块。开始使用未分级肝素进行保守治疗，并对肿块进行心脏 MRI 进一步评估，提示血栓最可能是诊断。尽管抗凝治疗 1 个月，肿块大小仍保持稳定，因此进行了 RA 血栓切除术和左肺动脉内膜切除术。组织病理学证实为血栓。患者在手术后 10 周死亡。
