A 64-year-old hypertensive man undergoing treatment with cisplatin for gastric adenocarcinoma presented to the emergencies with syncope. Blood pressure was recorded at 126/78mmHg, heart rate at 108 bpm, and an S1Q3T3 pattern was noted. The echocardiogram revealed the presence of a dilated right ventricle with a mobile mass in the right atrium and a lesion straddling the pulmonary trunk bifurcation. An angio-CT identified a 10mm thrombus in the right pulmonary artery branch (Fig. 1-A) and an elongated 35mm thrombus in the left branch (Fig. 1-B). After 24hours, an elongated 11cm thrombus (Fig. 2-arrow) was detected in transit through the interatrial septum (Fig. 2-asterisk). Surgical intervention was ultimately decided upon, and a pulmonary and cardiac thrombectomy followed by the closure of the patent foramen ovale were performed.
Conflicts of interest
None declared. The patient gave his informed consent for both the publication of the case and the iconography.
