Mularek-Kubzdela T, Grygier M, Grajek S, Cieśliński A
I Kliniki Kardiologii Instytutu Kardiologii Akademii Medycznej w Poznaniu.
Przegl Lek. 1997;54(7-8):515-9.
Right atrial thrombi have been diagnosed more frequently since the widespread use of two-dimensional echocardiography. The authors present current opinions on etiology of right heart thrombi. They can originate from two sources: type A thrombi originate in deep peripheral veins; they have worm-shape and they are extremely mobile or they develop within the right heart chambers-type B-they are then parietal and immobile. Clinical significance, prognosis in both types of thrombi is discussed and the guidelines for treatment are presented. Type A patients are a high risk group because of frequent incidence of severe pulmonary embolism and excessive mortality rate so aggressive therapy is required (surgery or fibrinolysis when surgery is contraindicated). Type B thrombi are much more benign, usually they do not lead to the death and treatment with anticoagulants seems to be sufficient.
自从二维超声心动图广泛应用以来，右心房血栓的诊断更为常见。作者阐述了关于右心血栓病因的当前观点。它们可源于两个来源：A型血栓起源于外周深静脉；呈蠕虫状，极具移动性，或者在右心腔内形成——B型血栓则位于心壁，不移动。文中讨论了这两种血栓的临床意义、预后，并给出了治疗指南。A型血栓患者是高危人群，因为严重肺栓塞的发生率高且死亡率过高，所以需要积极治疗（手术或在手术禁忌时进行纤维蛋白溶解治疗）。B型血栓的危害性小得多，通常不会导致死亡，抗凝治疗似乎就足够了。
