Extensive biatrial thrombus in transit across a patent foramen ovale: prompt diagnosis and management-a case report.

BACKGROUND

Thrombus in transit (TIT), a rare and life-threatening condition, poses risks of pulmonary and paradoxical embolism which needs prompt diagnosis. Our case report highlights the significance of utilizing advanced imaging techniques for accurate and timely diagnosis of TIT and the potential life-saving role of surgical thrombectomy. This case report discusses a rare instance of biatrial thrombus associated with venous thromboembolism (VTE) and patent foramen ovale (PFO). A 66-year-old female with multiple comorbidities presented with dyspnea and fatigue. Imaging revealed large thrombi in both atria, extending via PFO. Concurrent acute deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) were identified. Emergency cardiac surgery successfully removed the thrombi, emphasizing the diagnostic and management challenges associated with biatrial thrombus and PFO.

CONCLUSION

Point-of-care ultrasound (POCUS) plays a critical role in rapidly identifying TIT across a PFO. The time-sensitive and multidisciplinary medical management of TIT is crucial, requiring individualized strategies.

CLINICAL TRIAL NUMBER

Not applicable.

KEY CLINICAL MESSAGE

POCUS can be very helpful in providing a more appropriate image and more accurate diagnosis in patients with pulmonary embolism related to thrombus in transit (TIT) which is one of the most life-threatening medical conditions.