15Nov 2019

CAVITARY THROMBOSIS, A NEOPLASTIC COMPLICATION TO BE FEARED

  • Anesthesia and care unit service, national institute of oncology, Rabat Morocco
  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

Introduction:Thrombosis of the right cavities is rare, it concerns 4% of pulmonary emboli in the ICOPER register. This prevalence is probably underestimated . It must be considered as an immediate vital threat untreated, mortality is 80 to 100% Observation:We will report the case of a patient, hospitalized in the intensive care unit after a neoplastic surgery of the esophagus and for whom a transthoracic ultrasound performed because of respiratory distress and tachycardia objectified a right ventricular intracavitary thrombosis. Discussion:The presence of a moving right intra-atrial mass during pulmonary embolism confers a higher risk of death to the patient. This localization of thrombi could be explained by an embolization resulting from peripheral venous thrombosis , an impaired right ventricular systolic function an atrial rhythm disorder or a simple dilation of the atria. Authors have reported mechanisms caused by central venous catheter carbon monoxide poisoning . Heparin alone is insufficient in these patients, treatment may involve either surgical thrombectomy or intravenous thrombolysis. the generalization of ultrasound in the emergency and resuscitation departments as well as the training of practitioners should make it possible to diagnose thrombosis of the right heart chambers more early and, more generally, the existence of an acute pulmonary heart . Conclusion:Thrombosis of the right cavities is rare, it concerns 4% of pulmonary emboli Heparin alone is insufficient in these patients, even when the clinical condition is stable. Treatment may involve either surgical thrombectomy or intravenous thrombolysis. Therapeutic diagnosis and management is an emergency, because if not treated in time, the mortality is 80 to 100%.


  1. Torbicki A, Galie N, Covezzoli A, Rossi E, De Rosa M, Goldhaber SZ. Right heart thrombi in pulmonary embolism: results from the International Cooperative Pulmonary Embolism Registry. J Am Coll Cardiol 200341:2245?51.
  2. Rose PS, Punjabi NM, Pearse DB. Treatment of right heart thromboemboli. Chest 2002121:806?14.
  3. Burns KE, McLaren A. Catheter-related right atrial thrombus and pulmonary embolism: a case report and systematic review of the literature. CanRespir J J Can Thorac Soc 200916(5):163?5.
  4. Choi H, Kim D-H, Sun BJ, Kim J-S, Yang J, Kim S-M, et al. A case of carbon monoxide poisoning with thrombus in right atrium. J Cardiovasc Ultrasound 201220(4):205?8.
  5. European Working Group on Echocardiography. The European Cooperative Study on the clinical
  6. Rose PS, Punjabi NM, Pearse DB. Treatment of right heart thromboemboli.Chest 2002121:806?14.[7] Mollazadeh R, Ostovan MA,
  7. Pierre-Justin G, Pierard LA. Management of mobile right heart thrombi: aprospective series. Int J Cardiol 200599:381?8.
  8. Ferrari E, Benhamou M, Berthier F, Baudouy M. Mobile thrombi of theright heart in pulmonary embolism: delayed disappearance after thrombo-lytic treatment. Chest 2005127(3):1051?3
  9. Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Gali?N, et al. Task Force for the Diagnosis and Management of Acute PulmonaryEmbolism of the European Society of Cardiology (ESC). 2014 ESC gui-delines on the diagnosis and management of acute pulmonary embolism.Eur Heart J 201435(43):3033?69 [3069a?3069k]
  10. Pellegrini a,*, Y. Le Dolley b, B. Marot a, A. Riberi c, M. Bellezza a, F. Kerbaul? Interest of echocardiography in the diagnosis and monitoring of a pulmonary embolism complicating a freefloating thrombus in right heart cavities? 2012 Published by Elsevier Masson SAS on behalf of the French Anesthesia and Resuscitation Society (Sfar).

[Achraf Mouden, Smiti Yassine, Oussama Ssouni, Brahim El Ahmadi, Abdelilah Ghannam and Zakaria Belkhadir (2019); CAVITARY THROMBOSIS, A NEOPLASTIC COMPLICATION TO BE FEARED Int. J. of Adv. Res. 7 (Nov). 642-645] (ISSN 2320-5407). www.journalijar.com


achraf mouden
Anesthesia and care unit service, national institute of oncology, Rabat MOROCCO

DOI:


Article DOI: 10.21474/IJAR01/10052      
DOI URL: https://dx.doi.org/10.21474/IJAR01/10052