Interv Akut Kardiol 2011; 10(Suppl. A): 14-16

Thrombolytic therapy of pulmonary embolism with a mobile thrombus in the right heart

Zdeněk Monhart¹, Jan Sedláček¹, Milan Konvička²

¹ Interní oddělení, Nemocnice Znojmo

² Oddělení nukleární medicíny, Nemocnice Znojmo

The incidence of mobile thrombi in the right heart in pulmonary embolism is not very high, with the ICOPER registry reporting their

presence in 4 % of patients with pulmonary embolism. Mobile thrombi are more common in haemodynamically unstable patients. In

initially haemodynamically stable patients, their presence was associated with a higher mortality rate when the patients were treated

with heparin only. The therapeutic options include either thrombolytic therapy or surgical embolectomy. A case report presents a haemodynamically

stable patient with bilateral pulmonary embolism with a mobile thrombus in the right heart. Thrombolytic therapy resulted

in a rapid dissolution of the thrombus and a reduction in right ventricular dilatation and dysfunction.

Keywords: pulmonary embolism, mobile thrombi, thrombolytic therapy

Published: June 1, 2011  Show citation