Case Report: Right Atrial Thrombus with Pulmonary Embolism - Effect of Timely Medical Treatment
Charles O Masese1*, Joyce Chepkoech2, Timothy Wachira3, Anthony Gikonyo4, Premanand Ponoth5 and Dan Gikonyo4
1Head Cardiology Lecturer, The Karen Hospital Medical Training College, Langata Road, Nairobi 00200, Kenya
2Cardiology student, The Karen Hospital Medical Training College, Langata Road, Nairobi 00200, Kenya
3Lecturer, The Karen Hospital Medical Training College, Langata Road, Nairobi 00200, Kenya
4Cardiologist, The Karen Hospital Medical Training College, Langata Road, Nairobi 00200, Kenya
5Chief of Cardiothoracic & Vascular Surgery, The Karen Hospital Medical Training College, Langata Road, Nairobi 00200, Kenya
*Corresponding Author: Charles O Masese, Head Cardiology Lecturer, The Karen Hospital Medical Training College, Langata Road, Nairobi 00200, Kenya.
Published: October 01, 2024
Abstract  
Background: Right atrial thrombus (RAT) is a rare finding that is almost exclusively found complicating pulmonary embolism (PE) and carries a high mortality rate. Emergency treatment is usually required to save life. There is no algorithmic approach of the management of this condition due to the lack of evidence-based guidelines and randomized control trials. Management of RAT is still a subject of debate.
Objective: This study demonstrates the effectiveness of thrombolysis in resolution of right atrial thrombus.
Case Report: Sixty one year-old female, presented with a history of fainting, exertional dyspnea, easy fatigability, and lower limb swelling. A transthoracic echocardiography (TTE) showed a right atrial mass that was moving into right ventricle. Computed tomography pulmonary angiogram (CTPA) confirmed a diagnosis of pulmonary embolism.
The patient was thrombolysed with tenectaplase and a repeat TTE confirmed that the thrombus had resolved with and improvement in the patient’s clinical symptoms.
Discussion: This demonstrates thrombolysis is a rapid and life-saving therapeutic measure reducing the risk of death from thromboembolism.
Keywords: Cardiac Thrombus; Pulmonary Thromboembolism; Thrombolysis
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