A 52-year-old male was undergoing first-line chemotherapy with pemetrexed due to a stage IV right hilar lung adenocarcinoma with likely pleural, pericardial, liver, and bone metastases. During follow-up, no evidence of disease progression was found. Four years later a follow-up chest CT scan documented a nodular heterogeneous enhancement of the left ventricular (LV) myocardium (), the remaining lesions were overlapping. He had no cardiovascular symptoms and clinical examination was unremarkable. Transthoracic echocardiography () and cardiac MRI (Figures 1C-E) revealed several […]

A 33-year-old Brazilian man was admitted to the emergency department with sudden onset of global aphasia and right hemiparesis. An urgent CT angiography of the cerebral arteries confirmed the stroke diagnosis, showing an occlusion of the left internal carotid artery. The patient underwent systemic thrombolysis and mechanical thrombectomy with subsequent neurological improvement. Considering the stroke diagnosis in a young adult most likely of cardioembolic origin, he undertook a thorough diagnostic workup. Of importance, he had a family history of cardiomyopathy, […]

Introduction Right heart thrombus-in-transit is rare in the context of acute pulmonary embolism (APE) and is associated with high mortality and morbidity. , Transthoracic echocardiography (TTE) should always be performed in patients presenting dyspnea, chest pain, and hemodynamic instability. This case illustrates the importance of multimodality imaging in managing difficult cases with APE and right heart thrombus in transit, as well as the complications of this condition. A therapeutic approach should be decided on by multidisciplinary teams. […]