PMC6450230_01
Electrocardiogram showing sinus tachycardia (heart rate, 100 bpm) with incomplete right bundle branch block and minor nonspecific ST-T alterations
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F1
Electrocardiogram showed sinus tachycardia (heart rate: 100 bpm) with incomplete right bundle branch block and minor nonspecific ST-T alterations [Figure 1].
(Panel a) Transthoracic echocardiography in apical four-chamber view. Dilatation of right atrium and right ventricle. Large S-shaped RA thrombus (red arrow) entrapped in the Chiari network. LA = Left atrium, LV = Left ventricle, RA = Right atrium, RV = Right ventricle. (Panel b) Chest computed tomography scan with contrast showing obstructive thrombosis of the main pulmonary arteries. Ao = Aorta, PA = Pulmonary artery, T = Thrombus. (Panel c) Transthoracic echocardiography in apical four-chamber view showing the complete disappearance of the thrombus. LA = Left atrium, LV = Left ventricle, RA = Right atrium, RV = Right ventricle
JCE-29-32-g002.jpg
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F2
Surprisingly, it was also detected a large, S-shaped and extremely mobile right atrial thrombus, tethered to Chiari network, freefloating and prolapsing through the tricuspid valve into the right ventricle [Figure 2, panel a, red arrow]. During the following days, the echocardiographic reevaluation revealed the complete resolution of the thrombus from still enlarged right heart cavities [Figure 2, panel c].