PMC4845368_01
Thoracic CT-scan showing a consolidation in the right inferior lobe (arrow) interpreted as a pulmonary infarction due to pulmonary embolism from the cardiac thrombus
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Fig1
A second helical CT-pulmonary angiography was performed, showing a consolidation in the right inferior lobe (Fig. 1) and suspicion of a thrombus in the right ventricle (Fig. 2). Transthoracic echocardiography revealed an elongated highly mobile structure attached to the right ventricular septum extending through the right ventricle outflow tract and into the pulmonary trunk (Fig. 3, panel a, Additional file 1).
CT-pulmonary angiography that aroused suspicion of a thrombus in the right ventricle (arrow)
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Fig2
Supplemental contrast-enhanced imaging revealed no contrast uptake in the structure, consistent with a large right ventricular thrombus (Fig. 3, panel b, Additional file 2).
Transthoracic echocardiography showing a giant right intra-ventricular structure (arrow) in a parasternal short axis view (Panel a). The characteristic lack of contrast enhancement in the right intra-ventricular cavity confirms the presence of a giant right ventricular thrombus (Panel b)
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Fig3
Transthoracic echocardiography revealed an elongated highly mobile structure attached to the right ventricular septum extending through the right ventricle outflow tract and into the pulmonary trunk (Fig. 3, panel a, Additional file 1). Supplemental contrast-enhanced imaging revealed no contrast uptake in the structure, consistent with a large right ventricular thrombus (Fig. 3, panel b, Additional file 2). Cardiac magnetic resonance imaging (MRI) confirmed an approximately 7 cm long thrombus attached to the apical part of the right ventricular septum protruding through the pulmonary valve in systole, but retracting to just below the pulmonary valve in diastole (Fig. 4, Additional file 3).
Cardiac magnetic resonance imaging in a sagittal plane demonstrating the piston-like shape of the thrombus, and how it protrudes through the pulmonary valve in systole
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Fig4
Cardiac magnetic resonance imaging (MRI) confirmed an approximately 7 cm long thrombus attached to the apical part of the right ventricular septum protruding through the pulmonary valve in systole, but retracting to just below the pulmonary valve in diastole (Fig. 4, Additional file 3).