Title:Iatrogenic Right Atrial Thrombus Complicated by Pulmonary Embolism: Management and Outcomes

VOLUME: 17 ISSUE: 4

Author(s):Ayman Battisha*, Bader Madoukh, Khalid Sawalha and Brijesh Patel

Affiliation:Department of Internal Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA 01107, Overland Park Regional Medical Center-HCA Midwest Health, Overland Park, KS 66215, Department of Internal Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA 01107, Heart and Vascular Institute, West Virginian University, Medical Center, Morgantown, WV 26505

Keywords:Central venous catheters, right atrial thrombus, thromboembolism, pulmonary embolism, iatrogenic, transthoracic echocardiography.

Abstract:Right atrial thrombus can originate from distal venous sources or can be iatrogenic, secondary to the placement of central venous catheters, atrial devices, or surgeries. One of the most common complications of Central Venous Catheters (CVCs) is thromboembolism, which can be either fixed to the right atrium or can be free-floating. Device-related Right Atrial Thrombosis (RAT) can result in catheter occlusion, vascular occlusion, infection, and pulmonary embolism. The true incidence of these complications is unknown because the diagnosis may not be considered in asymptomatic patients, and it might be missed by Transthoracic Echocardiography (TTE). In this literature review, we discuss iatrogenic etiologies of RAT that is complicated by pulmonary embolism. We highlight the importance of maintaining a high index of suspicion of iatrogenic RAT, possible complications, and its management.