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  • Large free-floating right atrial mass presenting as intermediate-high risk pulmonary embolism: is reperfusion a better definite strategy?

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Case Reports: Learning from unexpected outcome (positive or negative)
Large free-floating right atrial mass presenting as intermediate-high risk pulmonary embolism: is reperfusion a better definite strategy?
  1. Mariana Martinho1,
  2. Rita Calé1,
  3. Filipa Ferreira1 and
  4. Helder Pereira1,2,3
  1. 1Cardiology Department, Hospital Garcia de Orta EPE, Almada, Portugal
  2. 2Cardiovascular Center of the University of Lisbon, Lisbon, Portugal
  3. 3Academic Medical Center of Lisbon, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
  1. Correspondence to Professor Helder Pereira; hhpereira{at}gmail.com

Abstract

We present a woman in her 60s diagnosed with an intermediate-high risk acute pulmonary embolism and a large, non-serpiginous right atrial (RA) mass. Conservative therapy with unfractionated heparin was started and further assessment of the mass with cardiac MRI suggested thrombus as the most likely diagnosis. Despite 1 month of anticoagulation, mass size remained stable and surgical RA embolectomy and left pulmonary endarterectomy was performed. Histopathology confirmed thrombus. The patient died 10 weeks after surgery.

  • Venous thromboembolism
  • Cardiothoracic surgery
  • Pulmonary embolism

https://doi.org/10.1136/bcr-2022-249225

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    Footnotes

    • Contributors MM is the main author of this work and was involved in patient care, diagnosis and therapeutic discussion, and also in article conception, writing and literature review. RC and FF were involved in diagnosis and therapeutic discussion and also participated in article conception and review. HP participated in the case review.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.