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Doodnauth AV, Choi CS, Dunkley JC, Zharovsky EM, Nguyen TM, Murkami N. Acute Saddle Embolus With Thrombus in Transit: A Case Report and Review of the Literature. Cureus 2022; 14:e25018. [PMID: 35719788 PMCID: PMC9198286 DOI: 10.7759/cureus.25018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2022] [Indexed: 12/03/2022] Open
Abstract
Pulmonary embolism is a life-threatening medical emergency associated with right ventricular failure. Rarely, it impacts the left ventricle to the point of compromising the left ventricular (LV) ejection fraction. We present a case of a 73-year-old African American male with a medical history pertinent for intravascular large B-cell lymphoma who developed an acute saddle embolus with a “clot-in-transit” and profound LV systolic dysfunction. Our report illustrates how an acute saddle embolus may be associated with LV systolic dysfunction via the “reverse Bernheim effect.” Additionally, the report highlights the significance of a “clot-in-transit” and LV systolic dysfunction, as they both directly correlate with increased risk of mortality.
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Fath AR, Eldaly AS, Aglan A, Varkoly KS, Beladi RN, Solsi A, Hahn MF, Karis JP, Nafisi S, Brady K, Bellamkonda P, Wakefield DN, Clapp WL, Lucas AR. Incidental Finding of a Large Right Atrial Thrombus in a Patient With Cerebral Lymphoma. J Investig Med High Impact Case Rep 2021; 9:23247096211001636. [PMID: 33749363 PMCID: PMC7985942 DOI: 10.1177/23247096211001636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Right atrial (RA) masses are rare, challenging to diagnose, and potentially life-threatening with high mortality if untreated. We present a patient presenting with diffuse large B-cell lymphoma in the brain that was incidentally found to have a large RA mass. For a better definition of the RA mass, extensive workup using multimodality imaging including chest computed tomography, transthoracic echocardiography, transesophageal echocardiography, cardiac magnetic resonance imaging, and left heart catheterization was warranted. The imaging demonstrated a large RA mass extending through the tricuspid valve into the right ventricle and superior and inferior vena cava without a mobile component. The mass was then successfully resected, and further histology examination was performed to rule out lymphoma and rare subtypes of diffuse large B-cell lymphoma. The comprehensive workup proved the RA mass to be a calcified thrombus rather than a direct metastatic spread of lymphoma.
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Affiliation(s)
| | | | - Amro Aglan
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | | | | | | - Mary F Hahn
- St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | | | | | | | | | | | | | - Alexandra R Lucas
- Creighton University, Phoenix, AZ, USA.,Dignity Health, Phoenix, AZ, USA.,Arizona State University, Tempe, AZ, USA
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