Pulmonary saddle thrombus

Thrombolysis for saddle pulmonary embolism and 3-chamber thrombus.

Currently, the only widely accepted indication for thrombolysis in cases of pulmonary embolism is hemodynamic instability. However, the presence of a right-heart thrombus along with pulmonary embolism is a poor prognostic indicator, and the use of thrombolytic agents should also be considered in this circumstance. Furthermore, despite a risk of distal embolization, thrombolytic therapy may be i...

Saddle Pulmonary Embolism with Thrombus in Transit across a Patent Foramen Ovale

This is the case of a 25-year-old obese man who presented with acute shortness of breath, chest pain, and palpitations. Of note, he lives a sedentary lifestyle and was recently hospitalized for incision and drainage of a left foot abscess. On presentation he was tachypnoeic, tachycardiac, and hypoxic but blood pressure was stable. Laboratory studies were significant for elevated D-dimer and mil...

Saddle pulmonary embolism visualized by transthoracic echocardiography.

Mobile right heart thrombus and pulmonary thromboembolism.

Large Substernal Thyroid Goiter Associated with Saddle Pulmonary Embolism

A 75-year-old woman with a longstanding history of a substernal thyroid goiter presented with acute shortness of breath, and she was intubated due to respiratory distress. Computed tomography (CT) scan revealed a compressive substernal goiter with associated vascular compression, axillosubclavian thrombosis, and saddle pulmonary embolism. Weight-based heparin was immediately administered, and t...