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Real-Time 3-Dimensional Transesophageal Echocardiography for the Diagnosis of a Thrombus Straddling the Patent Foramen Ovale
Journal of the American College of Cardiology © 2010 by the American College of Cardiology Foundation Published by Elsevier Inc.
Vol. 55, No. 4, 2010 ISSN 0735-1097/10/$36.00 doi:10.1016/j.jacc.2009.07.067
IMAGES IN CARDIOLOGY
Real-Time 3-Dimensional Transesophageal Echocardiography for the Diagnosis of a Thrombus Straddling the Patent Foramen Ovale Jean-Paul Rinaldi, MD, Decebal Gabriel Latcu, MD, Nadir Saoudi, MD, PHD Monaco
From Cardiologie, Centre Hospitalier Princesse Grace, Monaco. Manuscript received July 6, 2009, accepted July 20, 2009.
C
heck-up for a recent ischemic stroke in a 66-year-old man showed on transthoracic echocardiography dilated right cavities with arterial pulmonary hypertension. A mobile and serpentine 3-cm-long thrombus was seen in the left atrium, associated with a 4-cm-long thrombus in the right atrium (A). Real-time 3-dimensional transesophageal echocardiography showed the threatening thrombus entrapped in the patent foramen ovale (B and C, Online Video 1), floating in both cavities. Bilateral pulmonary embolism was present. The patient received continuous intravenous unfractionated heparin. Repeated transesophageal echocardiography revealed that the thrombus had disappeared after 4 days of treatment. In case of associated recent stroke or comorbidity, anticoagulant therapy is an acceptable alternative.
Vol. 55, No. 4, 2010 ISSN 0735-1097/10/$36.00 doi:10.1016/j.jacc.2009.07.067
IMAGES IN CARDIOLOGY
Real-Time 3-Dimensional Transesophageal Echocardiography for the Diagnosis of a Thrombus Straddling the Patent Foramen Ovale Jean-Paul Rinaldi, MD, Decebal Gabriel Latcu, MD, Nadir Saoudi, MD, PHD Monaco
From Cardiologie, Centre Hospitalier Princesse Grace, Monaco. Manuscript received July 6, 2009, accepted July 20, 2009.
C
heck-up for a recent ischemic stroke in a 66-year-old man showed on transthoracic echocardiography dilated right cavities with arterial pulmonary hypertension. A mobile and serpentine 3-cm-long thrombus was seen in the left atrium, associated with a 4-cm-long thrombus in the right atrium (A). Real-time 3-dimensional transesophageal echocardiography showed the threatening thrombus entrapped in the patent foramen ovale (B and C, Online Video 1), floating in both cavities. Bilateral pulmonary embolism was present. The patient received continuous intravenous unfractionated heparin. Repeated transesophageal echocardiography revealed that the thrombus had disappeared after 4 days of treatment. In case of associated recent stroke or comorbidity, anticoagulant therapy is an acceptable alternative.