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A challenging case of collapse with tri-fascicular block: from permanent pacemaker to thrombolysis

March 2016 Br J Cardiol 2016;23:39 doi:10.5837/bjc.2016.012

A challenging case of collapse with tri-fascicular block: from permanent pacemaker to thrombolysis

Luciano Candilio, Kavitha Aggarwal, Alexander W Chen, Nandkumar Gandhi, Shrilla Banerjee 

Abstract

Figure 1. A. Pre-thrombolysis transthoracic echocardiogram. Technically difficult study: large mobile thrombus extending from the tricuspid valve into the right ventricle; dilated right heart chambers (with impaired right ventricular function). B. Pre-thrombolysis transthoracic echocardiogram: in addition to the findings described in panel A, colour flow shows a jet of severe tricuspid valve regurgitation. C. Post-thrombolysis transthoracic echocardiogram: complete dissolution of the right heart thrombus (with improved right ventricular function). D. Postthrombolysis transthoracic echocardiogram: colour flow shows mild regurgitation only A 90

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