Key result
Trajectory-based framework integrates hemodynamics, RV function, and bleeding risk to manage right heart thrombus in PE.
Provides a trajectory-based framework for the management of right heart thrombus in acute pulmonary embolism, integrating contemporary ESC guidance and recent case series data.
Heterogeneity in right heart thrombus with acute PE supports individualized decisions; leaves open optimal strategies pending prospective data.
Right heart thrombus in acute pulmonary embolism is an uncommon finding with immediate prognostic and therapeutic implications. This focused narrative review integrates haemodynamic status, right ventricular function, thrombus context, bleeding risk, treatment selection, and serial imaging. Particular emphasis is placed on the 2024 case series by Teterina and colleagues, which demonstrates clinically important heterogeneity in presentation, management, and follow-up trajectories. Registry evidence and contemporary European Society of Cardiology guidance are used to develop a trajectory-based framework for stabilization, phenotype-based treatment, reassessment, and longitudinal follow-up.
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Braunwald Eugene (2026) conducted a review in Right heart thrombus in acute pulmonary embolism. Trajectory-based management was evaluated. A trajectory-based framework for managing right heart thrombus in acute pulmonary embolism integrates haemodynamic status, right ventricular function, and bleeding risk to guide treatment.
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