Published in:
01-01-2020 | Ultrasound | Imaging in Intensive Care Medicine
Detection of an inferior vena cava thrombus in transit by ultrasound
Published in: Intensive Care Medicine | Issue 1/2020
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A 70-year-old woman with dyspnea was admitted to the intensive care unit (ICU). The initial ultrasonography examination of the inferior vena cava (IVC) showed a free-floating thrombus distal to the confluence of hepatic veins (Fig 1, Video 1). A subsequent ultrasonography examination showed the migration of the thrombus into the right atrium (Fig 2, video 2). This was followed by cardiac arrest, presumably from massive pulmonary embolism. Resuscitation was not successful despite the immediate use of thrombolytic therapy.
Fig. 1
Longitudinal ultrasound slice of the IVC, a free floating caval thrombus near the confluence of hepatic veins. The thick white arrow, the thrombus in the IVC. The thin white arrow, the confluence of hepatic veins to IVC
Fig. 2
Longitudinal ultrasound slice of the IVC. An hour after Fig 1 and video 1 was captured, the thrombus was sliding into the heart. The white arrows, the thrombus. The a–c were continuously captured in 10 s, those figures showed the dynamic progress of the thrombus slipped into the heart
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