Key result
Anticoagulation completely resolves rare biatrial thrombi in acute PE without an interatrial shunt.
Why the study?
Biatrial thrombus formation in the absence of an interatrial shunt is a rare and poorly understood clinical presentation.
Case Report (n=1)
This case highlights the rare development of biatrial thrombi following catheter-directed mechanical thrombectomy for pulmonary embolism in the absence of an interatrial shunt.
Answers are grounded in this paper and cite their sources.
Clinicians should consider biatrial thrombi in select PE cases; this Level 5 report leaves open incidence, risks, and management implications.
In this rare case we describe a 56-year-old woman who presented with an acute pulmonary embolism (PE) complicated by right heart strain indicating the need for catheter-directed mechanical thrombectomy. Pre-operative two dimensional (2D) transthoracic echocardiogram (TTE) showed no evidence of intracardiac thrombi. Subsequently, post-operative 2D TTE indicated large biatrial thrombi with no evidence of PFO, or other intracardiac shunt. Here, we describe this rare and unique presentation and discuss the possible causes of such finding to help prompt diagnosis and guide management.
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Paul et al. (2021) conducted a case report in Acute pulmonary embolism with biatrial thrombi (n=1). Catheter-directed mechanical thrombectomy and anticoagulation was evaluated on Resolution of intracardiac thrombi. A 56-year-old woman with acute pulmonary embolism and right heart strain was found to have rare biatrial thrombi in sinus rhythm without an interatrial shunt, which completely resolved with anticoagulation.
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