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A Case of Multiple Pulmonary Elnbolism with Floating Right Atrial Throlnbus after PTCA Hidenari Matsumoto 1 , Toshihiko Seo 1 , Satoshi Watanabe 1 , Zyunya Ejiri 1 , Hiroyuki Masai 1 , Takahiro Hayashi 1 , Keizou Kawaguchi 1 , Chikao Kotake 1 , Tunenori Toda 1 , Katsuya Kobayashi 1 , Nobuhiro Tanimura 2 , Hiroaki Tsuruta 2 1Division of Cardiology, Saiseikai Nakatsu hospital 2Cardiac Surgery, Saiseikai Nakatsu Hospital Keyword: 肺塞栓症 , 右房内血栓 , 経皮的冠動脈形成術 , pulmonary embolism , right atrial thrombus PTCA pp.929-934
Published Date 1998/9/15
DOI https://doi.org/10.11477/mf.1404901765
  • Abstract
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A 46 year-old male was admitted to our hospital due to unstable angina on July 23, 1997. Coronary interven-tion to LCX was perfumed. On September 3. PTCA to LAI) was carried out but these was unsuccessful.

On the evening of August 10, the patient suddenly experienced difficulty in breathing and fell into shock. Right heart dilatation and a floating thrombus in the right atrium were observed in two-dimensional echogra-phy, so pulmonary embolism was diagnosed. His symp-toms and clinical state improved after anti-coagulation and thrombolysis. But lung perfusion scintigram revealed bilateral massive multiple defects and the floating right atrial thrombus still remained on two-dimensional echocardiography. Surgical thrum-bolectomy was performed, because it was highly pos-sible that lethal pulmonary embolism would occur. AA large quantity of thrombus was observed at the trunk ol the pulmonary artery and bilateral pulmonary arteries. The absence of thrombus on the right atrium and smooth right atrial wall suggested that it was embolized from peripheral veins. Pulmonary embolization often occurs repetitively, and the right atrial thrombus is actually due to the pulmonary embolism. It is necessary to select a therapeutic course with the need for surgical therapy in mind.


Copyright © 1998, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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