Saddle Thrombus seen on Transthoracic Echo: A Rare Feature in Pulmonary Embolism
DOI:
https://doi.org/10.17140/HROJ-2-109Abstract
The Saddle thrombus is a rare condition characterized by presence of a large thrombus
which straddles the main pulmonary arterial trunk and its bifurcation leading to acute massive
Pulmonary Embolism (PE). Its incidence among patients diagnosed with PE is approximately
2.6%.1 Saddle PE frequently results in significant hemodynamic instability and signals the potential
for imminent hemodynamic collapse. This is rarely seen on Trans-thoracic echocardiography
(TTE). We recently came across a patient who presented with breathlessness following
transatlantic air travel. His TTE (routine and 3D) revealed a saddle thrombus in the main pulmonary
arterial trunk extending into its two main branches (Figures 1 and 2). A CT pulmonary
angiogram confirmed the same (Figure 3). He was subsequently successfully thrombolyzed and
made an uneventful recovery.
References
Pruszczyk P, Pacho R, Ciurzynski M, et al. Short term clinical outcome of acute saddle pulmonary embolism. Heart. 2003; 89: 335-336. doi: 10.1136/heart.89.3.335 Heart Res Open J Page 52
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