Saddle pulmonary embolism and thrombus-in-transit straddling the patent foramen ovale 28 days after COVID symptom onset

Echocardiography. 2020 Aug;37(8):1296-1299. doi: 10.1111/echo.14796. Epub 2020 Jul 31.

Abstract

We present a late presentation of saddle pulmonary embolism and thrombus-in-transit straddle the patent foramen on patient who successfully recovered from severe acute respiratory syndrome coronavirus-2 (COVID-19) pneumonia. Seven days postdischarge (ie, 28 days after initial COVID-19 symptom onset), she was readmitted to hospital for severe dyspnea. Computer tomography angiogram and echocardiography confirmed the diagnosis. Severe pro-inflammatory and pro-thrombotic states with endothelial involvement have been reported associated with severe COVID-19 infection. However, the duration of hypercoagulable state has not yet known. This case highlights the risk of thromboembolic phenomena for prolonged periods of times after recovering from COVID-19 pneumonia.

Keywords: 2D echocardiography; computed tomography; embolism; pulmonary artery; right atrial thrombus.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anticoagulants / therapeutic use*
  • COVID-19 / complications*
  • Computed Tomography Angiography / methods
  • Dyspnea / etiology
  • Echocardiography / methods*
  • Enoxaparin / analogs & derivatives
  • Enoxaparin / therapeutic use
  • Female
  • Foramen Ovale, Patent / diagnostic imaging*
  • Heparin / therapeutic use
  • Humans
  • Patient Readmission
  • Pulmonary Embolism / diagnostic imaging*
  • Pulmonary Embolism / drug therapy
  • Pulmonary Embolism / etiology
  • Thrombosis / diagnostic imaging*
  • Thrombosis / drug therapy
  • Thrombosis / etiology

Substances

  • Anticoagulants
  • Enoxaparin
  • enoxaparin sodium
  • Heparin