Right Ventricle Thrombus in the Setting of Submassive Pulmonary Embolism

Rutul Patel; Anuja Mahesh Mistry; Venkatachalam Mulukutla; Krupal Prajapati

doi:10.7759/cureus.41161

Right Ventricle Thrombus in the Setting of Submassive Pulmonary Embolism

Cureus. 2023 Jun 29;15(6):e41161. doi: 10.7759/cureus.41161. eCollection 2023 Jun.

Authors

Rutul Patel¹, Anuja Mahesh Mistry¹, Venkatachalam Mulukutla², Krupal Prajapati³

Affiliations

¹ Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA.
² Interventional Cardiology, The Hospitals of Providence, El Paso, USA.
³ Internal Medicine, Nathiba Hargovandas Lakhmichand (NHL) Municipal Medical College, Ahmedabad, IND.

Abstract

Submassive pulmonary embolism (PE) with right heart strain and right ventricle thrombus is a complex and potentially life-threatening condition. Prompt recognition and management are crucial to optimizing patient outcomes. We present the case of a 59-year-old male with a history of obstructive sleep apnea (OSA) and non-compliance with continuous positive airway pressure (CPAP) therapy who presented with progressively worsening shortness of breath (SOB). Imaging studies revealed bilateral submassive PE with right heart strain and a thrombus in the right ventricle. Treatment included anticoagulation therapy and mechanical thrombectomy using the INARI FlowTriever device. This case highlights the importance of early recognition and risk factor assessment, such as using testosterone boosters, considering right ventricle thrombus as a complication of PE, and the role of mechanical thrombectomy in selected cases.

Keywords: anticoagulation; inari; mechanical thrombectomy; pulmonary embolism; right heart strain; right ventricle thrombus; submassive pulmonary embolism; testosterone; thrombus.

Publication types

Case Reports