Journal of Echocardiography

, Volume 13, Issue 4, pp 145–147 | Cite as

Pulmonary embolism due to right atrial free-floating thrombus during echocardiographic examination: a case of a pulmonary saddle thrombus

  • Mika Bando
  • Hirotsugu YamadaEmail author
  • Kenya Kusunose
  • Shuji Hayashi
  • Yuriko Takagawa
  • Yoshihito Saijo
  • Susumu Nishio
  • Kozue Ogasawara
  • Masataka Sata
Case Report


A 69-year-old female with polymyositis was referred to our hospital with a chief complaint of dyspnea. Transthoracic echocardiography showed right ventricular overloading. In addition to two-dimensional echocardiography, observation of the abnormal free-floating string-like mass by three-dimensional echocardiography provided superior visualization of the features of the mass which protruded into the right ventricle across the tricuspid valve during diastole. These findings enabled us to confirm the diagnosis of venous thrombus. The thrombus disappeared during the echocardiographic examination. Multidetector-row computed tomography showed a string-like thrombus across the bifurcation of the main pulmonary artery. Anticoagulation therapy was initiated with heparin and warfarin, and fondaparinux was started on the fourth day. Three-dimensional echocardiography was useful in characterizing the motion and extent of the thrombus.


Right atrial thrombus Pulmonary embolism Anticoagulation Echocardiography 


Compliance with ethical standards

Conflict of interest

Mika Bando, Hirotsugu Yamada, Kenya Kusunose, Shuji Hayashi, Yuriko Takagawa, Yoshihito Saijo, Susumu Nishio, Kozue Ogasawara, and Masataka Sata declare that they have no conflict of interest.

Human rights statements and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later revisions. Informed consent was obtained from the patient for being included in the study.

Supplementary material

Supplementary material 1 (WMV 5895 kb)

Supplementary material 2 (WMV 4504 kb)


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Copyright information

© Japanese Society of Echocardiography 2015

Authors and Affiliations

  1. 1.Department of Cardiovascular MedicineTokushima University HospitalTokushimaJapan

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