Pulmonary Embolism Management: Unraveling Controversies and Exploring Cutting-Edge Strategies (PG)-Clot In Transient CHEST PP 1

Clot In Transient CHEST PP 1

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The document presents a discussion and case studies on Clot In Transient (CIT), highlighting the importance of recognizing and addressing this medical emergency. CIT is associated with a high mortality rate of 40% and involves intracardiac thrombi that may pose a significant risk of embolization, especially Type A CIT, which is more common and linked with lower extremity deep vein thrombosis (LE DVT). Type A clots are elongated and wormlike, freely moving within heart chambers, while Type B clots have an oval shape, adhere to chamber walls, and generally carry a lower risk of embolization.<br /><br />Two cases are presented. The first involves a 35-year-old man with a history of venous thromboembolism (VTE) presenting with shortness of breath and chest pain, indicating a critical need for swift medical intervention. The second case involves a 51-year-old woman who experienced dizziness and syncope post-abdominoplasty, highlighting a different scenario of Type B CIT.<br /><br />Diagnostic imaging with CT pulmonary angiography (CTPA) is noted for its high sensitivity and specificity in identifying intracardiac thrombi, but the document stresses the utility of POCUS echocardiography as the gold standard for determining the thrombi's origin. Treatment varies based on patient comorbidities and the expertise of the medical center, including options like thrombolysis, anticoagulation, catheter-directed thrombolysis, and surgical thrombectomy.<br /><br />The document underscores the essential nature of emergent treatment and diagnosis using advanced imaging and echocardiographic techniques, emphasizing that CIT often correlates with patent foramen ovale (PFO) and pulmonary embolism, thereby requiring immediate and tailored intervention strategies.

Keywords

Clot In Transient

intracardiac thrombi

Type A CIT

Type B CIT

deep vein thrombosis

CT pulmonary angiography

POCUS echocardiography

thrombolysis

surgical thrombectomy

patent foramen ovale