Armstrong W F, Feigenbaum H, Dillon J C
Chest. 1985 Jun;87(6):801-6. doi: 10.1378/chest.87.6.801.
Deep venous thrombosis may result in the clinical syndrome of pulmonary embolus. In rare instances, embolization has occurred, not directly to the pulmonary arterial tree, but to the right atrium or right ventricle. We report herein two cases of right atrial thromboembolization detected by two-dimensional echocardiography, and we review recently reported similar cases. The echocardiographic appearance of right-sided cardiac thromboembolism may be unique and allow precise noninvasive diagnosis. Mortality was five of five in patients receiving no specific therapy, four of eight in medically treated patients, and one of seven in surgically treated patients. From this review, it appears that there is a high mortality associated with this entity, which may be improved by rapid recognition and institution of specific therapy with anticoagulants, thrombolytic agents, or surgery. In select patients with low surgical risk, prompt exploration and removal of the mass may be indicated.
深静脉血栓形成可能导致肺栓塞的临床综合征。在罕见情况下，栓子并非直接进入肺动脉树，而是进入右心房或右心室。我们在此报告两例经二维超声心动图检测到的右心房血栓栓塞病例，并回顾近期报道的类似病例。右侧心脏血栓栓塞的超声心动图表现可能具有独特性，可实现精确的无创诊断。未接受特异性治疗的患者死亡率为5/5，接受药物治疗的患者死亡率为4/8，接受手术治疗的患者死亡率为1/7。通过本次回顾发现，该疾病相关死亡率较高，通过快速识别并采用抗凝剂、溶栓剂或手术等特异性治疗措施，死亡率可能会降低。对于手术风险较低的特定患者，可能需要及时进行探查并切除肿块。
