Use of heparin alone in treating pulmonary emboli found in association with in-transit right-heart thrombi in a nonagenarian

• Published in: Texas Heart Institute journal Vol. 40; no. 4; pp. 487 - 488
• Main Authors: Temtanakitpaisan, Yutthapong, Mahatanan, Rattanaporn, Rishikof, David C, Young, David Z
• Format: Journal Article
• Language: English
• Published: United States Texas Heart Institute 2013
• Subjects: Aged, 80 and over; Anticoagulants - therapeutic use; Case Reports; Female; Heart Diseases - diagnosis; Heart Diseases - drug therapy; Heart Diseases - etiology; Heparin - therapeutic use; Humans; Pulmonary Embolism - diagnosis; Pulmonary Embolism - drug therapy; Pulmonary Embolism - etiology; Treatment Outcome; Venous Thrombosis - complications; Venous Thrombosis - diagnosis; Venous Thrombosis - drug therapy; heparin; coronary thrombosis/therapy; Aged, 80 and over; thrombolytic therapy; anticoagulant drugs; female; respiratory insufficiency/etiology; pulmonary embolism/etiology/ultrasonography
• ISSN: 0730-2347; 1526-6702

In patients who present with pulmonary embolism, right-heart thrombus is a rare condition that is associated with increased mortality rates, compared with pulmonary embolism alone. Thrombolytic therapy has been associated with a survival benefit in previous studies of pulmonary embolism arising from right-heart thrombus. However, older patients have been excluded from such studies because thrombolysis places them at excessively high risk of bleeding. We present a case, in a 92-year-old woman, of pulmonary embolism arising from right-heart thrombi that we successfully treated with heparin.