Cameron J, Pohlner P G, Stafford E G, O'Brien M F, Bett J H, Murphy A L
J Am Coll Cardiol. 1985 May;5(5):1239-43. doi: 10.1016/s0735-1097(85)80031-0.
The clinical, echocardiographic, hemodynamic, angiographic and pathologic features of five patients who had right heart thrombus are presented and their management is discussed. Two modes of presentation were recognized. In four patients, right heart thrombus complicated peripheral venous thrombosis and was associated with major pulmonary thromboembolism and right heart obstruction. In the fifth, it complicated myocarditis with heart failure and appeared to cause right heart obstruction. Two-dimensional echocardiography was diagnostic of right heart thrombus in four patients and showed evidence of right heart dysfunction in those with major pulmonary thromboembolism. The diagnosis was confirmed at surgery in three patients and at autopsy in one. Three patients successfully underwent surgical removal of the thrombus followed by anticoagulation. One patient was treated successfully with anticoagulation alone. The only death occurred in the patient with myocarditis.
本文介绍了5例右心血栓患者的临床、超声心动图、血流动力学、血管造影及病理特征，并讨论了其治疗方法。发现了两种表现形式。4例患者中，右心血栓合并外周静脉血栓形成，并伴有严重肺血栓栓塞和右心梗阻。第5例患者中，右心血栓合并心肌炎及心力衰竭，似乎导致了右心梗阻。二维超声心动图诊断出4例患者存在右心血栓，并显示出严重肺血栓栓塞患者存在右心功能障碍的证据。3例患者手术确诊，1例尸检确诊。3例患者成功接受了血栓手术切除，随后进行抗凝治疗。1例患者仅接受抗凝治疗即成功治愈。唯一的死亡病例发生在心肌炎患者中。
