A right atrial worm-like thrombus in an elderly patient: is enoxaparine treatment alone sufficient?

Abstract

A 86-year-old male, with a history of recent thromboembolic stroke, was admitted to our hospital because of sudden dyspnea due to right heart thrombus and pulmonary thromboembolism. Transthoracic echocardiography revealed floating snake-like thrombus in the right atrium. Because of his cerebral status contraindicated surgical intervention and thrombolytic therapy. medical therapy with only enoxaparin. His clinical and haemodynamic status improved in two days. Follow-up transthoracic echocardiography, performed 2 days after the initiation of therapy revealed complete resolution of the thrombus. Medical therapy can be an alternative to surgical therapy in high-risk patients who have right-heart thrombus and pulmonary thromboembolism. In this report, we present a case, a 86-year-old male patient with floating snake-like thrombus in the right atrium that caused a stroke and treated with only enoxaparin.