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  • Title: Right heart free-floating thrombus in a pregnant woman with massive pulmonary embolism: a case of 'emboli in transit'.
    Author: Açar G, Şimşek Z, Avci A, Aung SM, Koca F, Sağlam M, Kaymaz C.
    Journal: J Cardiovasc Med (Hagerstown); 2015 Jan; 16 Suppl 1():S51-4. PubMed ID: 21135590.
    Abstract:
    The mainstay of treatment for massive pulmonary embolism in nonpregnant individuals is urgent thrombolytic therapy, but experience with these drugs in pregnancy is limited. We report a case of a 36-year-old woman at 27 weeks' gestation who was admitted with a massive, life-threatening pulmonary embolism. The diagnosis was rapidly accomplished in the coronary care unit by transthoracic echocardiography that showed signs of pulmonary hypertension as well as a large, free-floating thrombus in the right heart. As she was hemodynamically unstable, we started treatment with tissue plasminogen activator resulting in complete resolution of cardiorespiratory symptoms. A live baby was delivered by Caesarean section at 37 weeks of gestation, and no complications were seen during the 1-year follow-up. The present case report emphasizes the pivotal role of repeat echocardiography in clinical decision-making and the life-saving potential of thrombolytic therapy without serious adverse effects.
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