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- W4309161470 abstract "We read with interest the Letter to the Editor regarding our recent publication in the Journal ( 1 Carrizales-Sepúlveda EF Mejía-Melara Q González-Dávila SE et al. Right ventricular thrombus in transit in a patient with COVID-19. J Emerg Med. 2022; 62: 566-568 Google Scholar ). First, we would like to thank the authors for their insightful analysis and comments on our work. In our article, we describe the case of a 62-year-old man that presented to our unit with COVID-19 and respiratory distress and required invasive mechanical ventilation. During his hospital stay, he experienced sudden hemodynamic instability that required escalating doses of vasopressors. When we evaluated the patient with the use of point-of-care cardiac ultrasound (POCCUS), we found a severely dilated right ventricle (RV) with systolic D-shape suggestive of acute RV pressure overload and a McConnell's sign, which is highly specific for a pulmonary embolism (PE). Along with this, we caught a thin, worm-like, highly mobile mass, suggestive of a thrombus that was clearly moving toward the main pulmonary artery. This is shown in Video 1 and Figure 1 of our article ( 1 Carrizales-Sepúlveda EF Mejía-Melara Q González-Dávila SE et al. Right ventricular thrombus in transit in a patient with COVID-19. J Emerg Med. 2022; 62: 566-568 Google Scholar ). With this finding, and in the context of a patient with hemodynamic instability and echocardiographic data of acute RV pressure overload, we made a diagnosis of a massive (high-risk) PE and decided to give intravenous thrombolytic therapy as recommended in the guidelines, which led to a rapid improvement in hemodynamic status and progressive decrease in vasopressor dose ( 2 Konstantinides SV Meyer G Becattini C et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020; 41: 543-603 Google Scholar )." @default.
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- W4309161470 date "2022-09-01" @default.
- W4309161470 modified "2023-09-27" @default.
- W4309161470 title "Right Ventricular Thrombus in Transit or Just a Right Heart Thrombus? Eppur si Muove!" @default.
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- W4309161470 doi "https://doi.org/10.1016/j.jemermed.2022.07.010" @default.
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