Multicavitary thrombosis passing from the right atrium through the foramen ovale to the left atrium and left ventricle in a patient with bilateral pulmonary thromboembolism and deep vein thrombosis

Abstract

Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is the third most common cardiovascular disease after myocardial infarction and stroke. It occurs in about 70 out of 100,000 people each year, and the frequency tends to increase gradually, along with an increase in life expectancy and an increase in the number of cancer patients. The presence of thrombosis in the right heart cavities in combination with pulmonary thromboembolism occurs with a frequency of 3 to 23% and is associated with increased mortality even in patients who present with a stable clinical picture and hemodynamic parameters. Particularly high mortality is associated with the presence of a thrombus trapped or passing through an patented foramen oval. The present clinical case presents a successful thrombolytic treatment of a rare variant of multicavitary intracardiac thrombosis, passing from the right atrium through the foramen oval to the left atrium and passing through the mitral valve into the left ventricle in a patient with massive pulmonary thrombosis.