Mobile right heart thrombus with pulmonary embolism in a patient with polycythemia rubra vera and splanchnic vein thrombosis

Abstract

Splanchnic vein thrombosis in patients with polycythemia rubra vera is well-known. Development of mobile right heart thrombus in these patients has not been reported previously. We describe a young patient with Polycythemia rubra vera and splanchnic vein thrombosis with ischemic bowel who underwent small bowel resection. He developed a large mobile right atrial thrombus and bilateral pulmonary embolism. He also had upper gastrointestinal bleed. His management was complicated and challenging due to multiple risk factors and co-morbid conditions. Thrombolysis was contraindicated and he refused surgical intervention. He was treated with anticoagulation with complete resolution of right atrial thrombus.

Keywords

• right heart thrombus
• Right atrial thrombus
• Pulmonary embolism
• Polycythemia rubra vera
• Splanchnic vein thrombosis