Case Report

Snake-Like Thrombus in the Right Heart Causing Massive Pulmonary Embolism and a Basic but Important Diagnostic Tool for Rapid Differential Diagnosis: Transthoracic Echocardiography


  • Zekeriya Küçükdurmaz
  • Yıldız Doğan
  • Mustafa Kemal Avşar
  • Fahri Hayri Atlı
  • Hasan Büyükaslan

Received Date: 01.05.2010 Accepted Date: 17.06.2010 Eurasian J Emerg Med 2013;12(2):98-100

We present a case diagnosed as massive pulmonary embolism in whom a snake-like thrombus was found in the right heart by transthoracic echocardiography, which is a basic but important diagnostic tool for rapid differential diagnosis. It is non-invasive and relatively cheap and can eliminate the necessity for complex and expensive diagnostic tools that are also inconvenient for these type patients who are hypotensive, cyanotic and confused. Pulmonary embolism is a life-threatening condition. 2/3 of the PTE cases are misdiagnosed. Some highly sensitive symptoms of massive pulmonary thromboemboli (PTE) like dyspnea, hypotension, angina pectoris and syncope have low specificity for PTE, though sometimes these patients are misdiagnosed or diagnosed late causing a delay in instituting the appropiate therapy. Transthoracic echocardiography is also useful for the differential diagnosis to eliminate the other causes which can trigger the similar symptoms.

Keywords: Pulmonary, thromboembolisation, echocardiography, thrombus