Caught in Transit: Mobile Right Atrial Thrombus in Intermediate-High-Risk Pulmonary Embolism Treated With Half-Dose Alteplase

Wael Gomaa; Khaled Sewify; Eslam Elsayed Abdelshafey; Abdulaziz Alsaher; Ragheb Elmessery; Fadah Alanazi; Adel Azmy; Khalid Al Faraidy

doi:10.12659/AJCR.952646

07 May 2026 : Case report Saudi Arabia

Caught in Transit: Mobile Right Atrial Thrombus in Intermediate-High-Risk Pulmonary Embolism Treated With Half-Dose Alteplase

Unusual clinical course, Challenging differential diagnosis, Diagnostic / therapeutic accidents, Management of emergency care, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)

Wael Gomaa^{ABCDEF 1}, Khaled Sewify^{ABCDEF 1*}, Eslam Elsayed Abdelshafey^{ABCEF 1}, Abdulaziz Alsaher^{D 1}, Ragheb Elmessery^{CDEF 1}, Fadah Alanazi^{CD 1}, Adel Azmy^{D 2}, Khalid Al Faraidy

^{D 2}

DOI: 10.12659/AJCR.952646

Am J Case Rep 2026; 27:e952646

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Introduction Case Report Discussion Conclusions References

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Figure 1 Transthoracic echocardiography demonstrating a mobile echogenic mass in the right atrium consistent with clot-in-transit, with associated right ventricular dilation. Labels denote right atrium (RA), right ventricle (RV), left ventricle (LV), and interatrial septum (IAS); the clot-in-transit is highlighted by an arrow.

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Caught in Transit: Mobile Right Atrial Thrombus in Intermediate-High-Risk Pulmonary Embolism Treated With Half-Dose Alteplase

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