PMC10161827_01
A: dilation of the pulmonary artery is observed as well as thrombi in both main branches. B: tricuspid insufficiency. The Doppler velocity signal is 4.6 m/sec and a ventricular-atrial gradient of 72.48 mmhg with an estimated systolic pulmonary pressure of 86 mmhg. C: time-velocity integral of RVOT of 7.6 cm that indates a low right ventricular output.
7567AX221-ACM-93-26-g001.jpg
PMC10161827_01_7567AX221-ACM-93-26-g001.jpg
F1
Computed tomography angiography of the thorax was done (Fig. 1A), which revealed PE in bilateral main pulmonary artery and segmental arteries involvement also a thrombus at inferior vena cava and right atrium (RA) was informed (Fig. 1B). A large serpiginous thrombus in the RA extending to the RV across the tricuspid valve and also an extension of this mass to the mitral valve is shown (Figs. 1C and 2A).
A: image of serpenteginous thrombus is observed that crosses the patent foramen ovale and goes to the mitral valve. B: thrombus is observed in the right atrium that enters the right ventricular outflow tract and passes through the patent foramen ovale. C: large thrombotic load is observed in both branches of the pulmonary arteries.
7567AX221-ACM-93-26-g002.jpg
PMC10161827_01_7567AX221-ACM-93-26-g002.jpg
F2
A large serpiginous thrombus in the RA extending to the RV across the tricuspid valve and also an extension of this mass to the mitral valve is shown (Figs. 1C and 2A).
Thrombus displacement by mitral valve. Is observed a wobble of the thrombus in the anterior leaflet of the mitral valve.
7567AX221-ACM-93-26-g003.jpg
PMC10161827_01_7567AX221-ACM-93-26-g003.jpg
F3
Transesophageal echocardiogram showed a large thrombus floating in the RA with a segment being entrapped through a PFO extending to the mitral valve (Figures 3 and 4).
Transesophageal echocardiogram: Thrombus at patent foramen ovale.
7567AX221-ACM-93-26-g004.jpg
PMC10161827_01_7567AX221-ACM-93-26-g004.jpg
F4
Transesophageal echocardiogram showed a large thrombus floating in the RA with a segment being entrapped through a PFO extending to the mitral valve (Figures 3 and 4).