PMC7417042_01
Electrocardiogram (ECG) at admission showing sinus rhythm with normal QRS morphology and mild QTc prolongation
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PMC7417042_01_1644_Fig1.jpg
f1-1644-1-13382-1-10-20200512
An electrocardiogram (ECG) showed sinus rhythm, normal QRS morphology, a prolonged QTc interval at 470 ms and no features of ischaemia (Fig. 1). The on-call cardiology team was contacted to perform emergent bedside echocardiography, which revealed complete occlusion of the RV and right atrium (RA) by thrombus, and severe LV systolic impairment with spontaneous echo contrast in the LV and left atrium (LA) (Figs. 2A and 2B, Videos 1 and 2).
(A) and (B): Complete occlusion of the right ventricular cavity by thrombus and spontaneous echo contrast in the left ventricle. (C) and (D): Resolution of right ventricular thrombus 15 minutes post-initiation of intravenous thrombolysis
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PMC7417042_01_1644_Fig2.jpg
f2-1644-1-13382-1-10-20200512
The on-call cardiology team was contacted to perform emergent bedside echocardiography, which revealed complete occlusion of the RV and right atrium (RA) by thrombus, and severe LV systolic impairment with spontaneous echo contrast in the LV and left atrium (LA) (Figs. 2A and 2B, Videos 1 and 2). Repeat TTE performed 15 minutes post-thrombolysis demonstrated complete resolution of the RHT, as well as improvement in both RV and LV systolic function (Figs. 2C and 2D, Videos 3 and 4).
Apical 4-chamber view pre-thrombolysis demonstrating complete occlusion of the right heart chambers with severe left ventricular systolic impairment.. View it here: https://youtu.be/dTPXEoLZtm4
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PMC7417042_01_1644_Fig3.jpg
f3-1644-1-13382-1-10-20200512
Repeat TTE performed 15 minutes post-thrombolysis demonstrated complete resolution of the RHT, as well as improvement in both RV and LV systolic function (Figs. 2C and 2D, Videos 3 and 4).
Subcostal view pre-thrombolysis demonstrating complete occlusion of the right heart chambers with severe left ventricular systolic impairment.. View it here: https://youtu.be/TGA9JKc3WhE
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PMC7417042_01_1644_Fig4.jpg
f4-1644-1-13382-1-10-20200512
Repeat TTE performed 15 minutes post-thrombolysis demonstrated complete resolution of the RHT, as well as improvement in both RV and LV systolic function (Figs. 2C and 2D, Videos 3 and 4).