American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: http://www.sciepub.com/journal/ajmcr Editor-in-chief: Samy, I. McFarlane
Open Access
Journal Browser
Go
American Journal of Medical Case Reports. 2020, 8(2), 67-69
DOI: 10.12691/ajmcr-8-2-7
Open AccessArticle

A Case of Thrombus in Transit: Role of POCUS in Early Diagnosis of Pulmonary Thromboembolism

Pramod Theetha Kariyanna1, Jessica Celenza-Salvatore1, Apoorva Jayarangaiah2, George Jojo Punnakudiyil3 and Isabel M. McFarlane1,

1Division of Cardiovascular Diseases and Department of Internal Medicine, State University of New York, Downstate Medical Center, Brooklyn NY 11203, USA

2Division of Hematology- Oncology, Department of Internal Medicine, Albert Einstein College of medicine/ Jacobi Medical Center, Bronx, N.Y., U.S.A 10461

3Department of Internal Medicine, Brookdale University Hospital and Medical Center, Brooklyn, New York 11212

Pub. Date: January 07, 2020

Cite this paper:
Pramod Theetha Kariyanna, Jessica Celenza-Salvatore, Apoorva Jayarangaiah, George Jojo Punnakudiyil and Isabel M. McFarlane. A Case of Thrombus in Transit: Role of POCUS in Early Diagnosis of Pulmonary Thromboembolism. American Journal of Medical Case Reports. 2020; 8(2):67-69. doi: 10.12691/ajmcr-8-2-7

Abstract

Pulmonary embolism is a cause of significant morbidity and mortality. Thrombus in transit is defined on ultrasound as mobile echogenic material, temporarily located in the right heart chambers making its way to the pulmonary vasculature, which is highly diagnostic of pulmonary embolism. Point-of-care ultrasound (POCUS) places significant role in early diagnosis of thrombus in transit. Point-of-care ultrasound also avoids the need for subsequent computed tomography angiogram for diagnosis of pulmonary embolism. We present the case of 53-year-old male who presented with shortness of breath and was noted to have sinus tachycardia; thrombus in transit was diagnosed by point-of-care ultrasound and was subsequently confirmed through computer tomography angiogram of the pulmonary artery.

Keywords:
thrombus in transit point-of-care ultrasound pulmonary embolism S1Q3T3

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Horlander KT, Mannino DM, Leeper KV. Pulmonary embolism mortality in the United States, 1979-1998: an analysis using multiple-cause mortality data. Arch Intern Med 2003; 163: 1711.
 
[2]  Arya R. Venous thromboembolim prevention. London: Department of Health, 2009.
 
[3]  The European Cooperative Study on the clinical significance of right heart thrombi. European Working Group on Echocardiography. Eur Heart J. 1989; 10: 1046e1059.
 
[4]  Arboine-Aguirre L, Figueroa-Calderón E, Ramírez-Rivera A, et al. Thrombus in transit and submassive pulmonary thromboembolism successfully treated with tenecteplase. Gac Med Mex. 2017; 153(1): 129-33.
 
[5]  Chartier L, Béra J, Delomez M, et al. Free-floating thrombi in the right heart: diagnosis, management, and prognostic indexes in 38 consecutive patients. Circulation. 1999;99(21):2779–83
 
[6]  Kahl, N., Gabriel, C., Lahham, S., Thompson, M., & Hoonpongsimanont, W. (2019). Point-of-Care Ultrasound Diagnosis of Pulmonary Embolism with Thrombus in Transit. Clinical Practice and Cases in Emergency Medicine, 3(1).
 
[7]  Vratika Agarwal, Nikhil Nalluri, Masood A. Shariff, Muhammad S. Akhtar, Yefim Olkovsky, Paul E. Kitsis, John P. Nabagiez, Large embolus in transit – An unresolved therapeutic dilemma (case report and review of literature),Heart & Lung, Volume 43, Issue 2, 2014, Pages 152-154,ISSN 0147-9563.
 
[8]  João Português, Lucy Calvo, Margarida Oliveira, et al., “Pulmonary Embolism and Intracardiac Type A Thrombus with an Unexpected Outcome,” Case Reports in Cardiology, vol. 2017, Article ID 9092576, 5 pages, 2017.