{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T06:26:14Z","timestamp":1771655174473,"version":"3.50.1"},"reference-count":20,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>An 89-year-old woman came with symptoms of progressively worsening dyspnoea at rest over the preceding week. She was normotensive, had elevated jugular venous pressure and clear lungs. ECG revealed atrial fibrillation with the rapid ventricular rate. Labs were significant for markedly elevated pro-brain natriuretic peptide of 43\u2005000\u2005pg\/mL and troponin-T of 1\u2005ng\/mL. An urgent 2D echocardiogram was obtained, which revealed the severely dilated right atrium and a large linear mobile mass in the right atrium consistent with a thrombus. An emergent CT scan revealed multiple bilateral pulmonary emboli. She received intravenous tissue plasminogen activator. Repeat echocardiogram performed 6\u2005h later showed no evidence of the right atrial thrombus. She was subsequently maintained on intravenous heparin and transitioned to Coumadin. Early recognition of this rare but potentially fatal complication is important as prompt treatment measures can help in preventing life-threatening complications of the right atrial thrombus.<\/jats:p>","DOI":"10.1136\/bcr-2013-010255","type":"journal-article","created":{"date-parts":[[2013,7,26]],"date-time":"2013-07-26T08:27:58Z","timestamp":1374827278000},"page":"bcr2013010255","source":"Crossref","is-referenced-by-count":2,"title":["Successful treatment of mobile right atrial thrombus and acute pulmonary embolism with intravenous tissue plasminogen activator"],"prefix":"10.1136","volume":"2013","author":[{"given":"R","family":"Bajaj","sequence":"first","affiliation":[{"name":"Division of Cardiology, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajay","family":"Ramanakumar","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suresh","family":"Mamidala","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Massachusetts Medical School, Saint Vincent Hospital, Worcester, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepti","family":"Kumar","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,7,26]]},"reference":[{"key":"2025082703134961000_2013.jul25_2.bcr2013010255.1","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1378\/chest.121.3.806","article-title":"Treatment of right atrial thromboemboli","volume":"2013","author":"Rose","year":"2002","journal-title":"Chest"},{"key":"2025082703134961000_2013.jul25_2.bcr2013010255.2","doi-asserted-by":"crossref","first-page":"40","DOI":"10.5414\/CNP59040","article-title":"Large atrial thrombus formation associated with tunnelled cuffed haemodialysis catheters","volume":"2013","author":"Negulescu","year":"2003","journal-title":"Clin Nephrol"},{"key":"2025082703134961000_2013.jul25_2.bcr2013010255.3","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/s10554-005-7438-3","article-title":"Imminent pulmonary embolism: a fatal mobile right atrial thrombus","volume":"2013","author":"Basarici","year":"2006","journal-title":"Int J Cardiovasc Imaging"},{"key":"2025082703134961000_2013.jul25_2.bcr2013010255.4","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1016\/S0735-1097(84)80069-8","article-title":"Right atrial thromboemboli: clinical, echocardiographic and pathophysiologic manifestations","volume":"2013","author":"Felner","year":"1984","journal-title":"J Am Coll Cardiol"},{"key":"2025082703134961000_2013.jul25_2.bcr2013010255.5","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1136\/heart.89.10.1252","article-title":"Giant right atrial thrombosis associated with Hickman catheter","volume":"2013","author":"Kula","year":"2003","journal-title":"Heart"},{"key":"2025082703134961000_2013.jul25_2.bcr2013010255.6","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1016\/S1051-0443(98)70313-6","article-title":"Giant right atrial thrombus: a life-threatening complication of long-term central venous access catheters","volume":"2013","author":"Forauer","year":"1998","journal-title":"J Vasc Interv Radiol"},{"key":"2025082703134961000_2013.jul25_2.bcr2013010255.7","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1378\/chest.95.4.930","article-title":"Giant right atrial thrombus in Noonan syndrome combined with Eisenmenger's complex","volume":"2013","author":"Tatsukawa","year":"1989","journal-title":"Chest"},{"issue":"11 Suppl","key":"2025082703134961000_2013.jul25_2.bcr2013010255.8","first-page":"1723","article-title":"Pulmonary embolism and thrombi of the right heart","volume":"2013","author":"Chapoutot","year":"1995","journal-title":"Arch Mal Coeur Vaiss"},{"key":"2025082703134961000_2013.jul25_2.bcr2013010255.9","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1007\/s11239-007-0063-3","article-title":"Echocardiographic diagnosis of a giant thrombus passing through a patent foramen ovale from right atrium to the left atrium","volume":"2013","author":"Bugra","year":"2008","journal-title":"J Thromb Thrombolysis"},{"key":"2025082703134961000_2013.jul25_2.bcr2013010255.10","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1161\/01.CIR.77.2.353","article-title":"Intravenous and intrapulmonary recombinant tissue-type plasminogen activator in the treatment of acute massive pulmonary embolism","volume":"2013","author":"Verstraete","year":"1988","journal-title":"Circulation"},{"key":"2025082703134961000_2013.jul25_2.bcr2013010255.11","doi-asserted-by":"crossref","first-page":"261","DOI":"10.2143\/AC.55.4.2005749","article-title":"Surgical treatment of cardiogenic shock due to huge right atrial thromboembolus","volume":"2013","author":"Baltalarli","year":"2000","journal-title":"Acta Cardiol"},{"key":"2025082703134961000_2013.jul25_2.bcr2013010255.12","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1111\/j.1540-8191.1996.tb00077.x","article-title":"Management of mobile right atrial thrombi: a therapeutic dilemma","volume":"2013","author":"Shah","year":"1996","journal-title":"J Card Surg"},{"key":"2025082703134961000_2013.jul25_2.bcr2013010255.13","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.ijcard.2003.10.071","article-title":"Management of mobile right heart thrombi: a prospective series","volume":"2013","author":"Pierre-Justin","year":"2005","journal-title":"Int J Cardiol"},{"key":"2025082703134961000_2013.jul25_2.bcr2013010255.14","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1111\/j.1540-8175.2000.tb01144.x","article-title":"Large right atrial thrombus with pulmonary embolism","volume":"2013","author":"Hung","year":"2000","journal-title":"Echocardiography"},{"key":"2025082703134961000_2013.jul25_2.bcr2013010255.15","first-page":"877","article-title":"Thrombi of the right heart. Value of thrombolytic therapy in mobile thrombi","volume":"2013","author":"Fournier","year":"1992","journal-title":"Arch Mal Coeur Vaiss"},{"key":"2025082703134961000_2013.jul25_2.bcr2013010255.16","first-page":"805","article-title":"Floating thrombus in the right atrium and severe pulmonary embolism. Value of intravenous thrombolysis","volume":"2013","author":"Leclercq","year":"1994","journal-title":"Arch Mal Coeur Vaiss"},{"key":"2025082703134961000_2013.jul25_2.bcr2013010255.17","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1002\/clc.4960220222","article-title":"Thrombolysis of mobile right atrial thrombi following severe pulmonary embolism","volume":"2013","author":"Cracowski","year":"1999","journal-title":"Clin Cardiol"},{"key":"2025082703134961000_2013.jul25_2.bcr2013010255.18","first-page":"441","article-title":"Thrombolytic treatment of type A right atrial thrombi: description of three cases and review of the literature","volume":"2013","author":"Mezzani","year":"1999","journal-title":"G Ital Cardiol"},{"key":"2025082703134961000_2013.jul25_2.bcr2013010255.19","first-page":"253","article-title":"Successful treatment of a catheter-related right atrial thrombosis with recombinant tissue plasminogen activator and heparin","volume":"2013","author":"Cesaro","year":"2002","journal-title":"Support Care Cancer"},{"key":"2025082703134961000_2013.jul25_2.bcr2013010255.20","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1097\/01.PCC.0000149681.08212.2E","article-title":"Management of a large organized intraatrial catheter-tip thrombus in a child with acquired immunodeficiency syndrome using escalating tissue plasminogen activator infusions","volume":"2013","author":"Mathur","year":"2005","journal-title":"Pediatr Crit Care Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2013-010255","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T10:14:02Z","timestamp":1756289642000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2013-010255"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,7,26]]},"references-count":20,"alternative-id":["10.1136\/bcr-2013-010255"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2013-010255","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,7,26]]}}}