Patient:
Male, 73 FINAL DIAGNOSIS: Coronary artery thrombosis Symptoms: Angina pectoris • short of breath
Medication:
- Clinical Procedure: CABG Specialty: Cardiology.
Objective:
Management of emergency care.
Background:
Intra-operative formation of a thrombus in the right heart is rare and might be unrecognized. However, it can be associated with severe consequences, including pulmonary embolism and death.
Case report:
We report the case of a 73-year-old man who presented to the cardiologist with angina pectoris and rare shortness of breath. Coronary artery bypass grafting (CABG) was performed due to multi-vessel disease. Because of hemodynamic insufficiency, an intra-operative transesophageal echocardiogram (TEE) was performed and a huge free-floating thrombus was detected. Multiple thrombi were removed from the right heart and pulmonary arteries. The patient died after cardiopulmonary bypass support and 12 hours of intensive care.
Conclusions:
In this case report, we emphasize the importance of the TEE during the preoperational period and during CABG, as well as in the preoperative evaluation of pulmonary hypertension.