Abstract
Right heart thrombi are detected in approximately 4% of patients with pulmonary embolism. The associated mortality is high, but the optimal strategy remains controversial. We report a case of a large mobile right heart thrombus, complicated by embolism of the right pulmonary artery, which was successfully treated with half-dose alteplase. We briefly review the literature and discuss the therapeutic options, focusing on the advantages of thrombolysis.LEARNING POINTSMobile right heart thrombi require rapid therapeutic choices between surgical thrombectomy and thrombolysis.Half-dose alteplase may be effective, even in the presence of an extensive thrombus burden.
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