Management of hemodynamic collapse in the setting of right atrial thrombus
Patient is a 47 year old female with PMH of metastatic leiomyosarcoma originating in the IVC and right atrial thrombus who was admitted for gastric outlet obstruction 2/2 external compression by metastases. Her hospital course was complicated by the development of refractory hypotension with lactic acidosis after mediport placement. Echocardiogram was notable for progression of right atrial mass, now encompassing majority of the RA and sitting across tricuspid valve. Patient with worsening hemodynamic and respiratory status requiring intubation and maximum vasopressors. We will discuss clinical management strategies for patients with thrombus-related obstructive right heart failure.
Niederhauser A, Donatelli D, Soto R. Management of hemodynamic collapse in the setting of right atrial thrombus. Presented at: American Society of Anesthesiology Annual Meeting; 2022 Oct 21-25; New Orleans, LA.