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Case Reports
. 2014 May-Jun;27(3):390-3.
doi: 10.20344/amp.4737. Epub 2014 Jun 30.

Large right ventricular thrombus

Carla Sousa  1 , Pedro Almeida  1 , Alexandra Gonçalves  1 , João Rodrigues  1 , Inês Rangel  1 , Filipe Macedo  1 , M Júlia Maciel  1
Affiliations
Free article
Case Reports

Large right ventricular thrombus

Carla Sousa et al. Acta Med Port. 2014 May-Jun.
Free article

Abstract
in English, Portuguese

Right ventricular thrombosis is a rare yet potentially fatal condition. It has been described in association with hypercoagulability states, autoimmune diseases and dilated cardiomyopathy. Echocardiography constitutes the election tool for diagnosis and characterization of these entities, allowing for the differentiation between the various types of thrombi. We present a case of a patient with alcoholic dilated cardiomyopathy admitted for congestive heart failure and lower respiratory infection. In the diagnostic approach, a routine echocardiography revealed a large mural right ventricular thrombus in association with severe biventricular dysfunction. The patient was proposed for anticoagulation strategy, which he refused.

A formação de trombos no ventrículo direito corresponde a uma situação rara porém potencialmente fatal. Tem sido descrita em associação a estados de hipercoagulabilidade, doenças autoimunes e cardiopatia dilatada. A ecocardiografia constitui o método de eleição para o diagnóstico e caracterização destas estruturas, permitindo, inclusive, a diferenciação entre os diversos tipos de trombos possíveis. Apresentamos o caso de um doente com miocardiopatia dilatada de etiologia alcoólica que foi admitido por insuficiência cardíaca congestiva e infeção respiratória baixa. Durante a marcha diagnóstica, o ecocardiograma de rotina revelou a presença de um volumoso trombo mural no ventrículo direito, em associação a disfunção sistólica biventricular de grau severo. Foi proposto o início de hipocoagulação oral, estratégia que o doente recusou.

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