A Case of Acute Submassive Pulmonary Thromboembolism with Right Heart Thrombi That Was Successfully Treated with Mutant Tissue Plasminogen Activator during Continuous Echocardiographic Monitoring

Abstract

The patient was a 51-year-old woman who was admitted to a nearby hospital because of exertional dyspnea since 10 days prior. Transthoracic echocardiography revealed a mobile mass prolapsing through the tricuspid valve and right ventricular overload. Computed tomography showed a large amount of thrombi in both main pulmonary arteries. The diagnosis was submassive pulmonary thromboembolism (PTE) with right heart thrombi (RHT), and she was referred to our hospital. Thrombolytic therapy was performed under continuous echocardiographic monitoring and confirmed complete lysis of the RHT within 22 minutes. Submassive PTE with RHT was successfully treated with thrombolytic therapy during continuous echocardiographic monitoring.