Real-time monitoring of the giant right atrial thrombus prolapsing into the right ventricle and the deterioration of the thrombus with thrombolytic treatment by transthoracic echocardiography

A 57-year-old male with a history of metastatic pancreatic adenocancer presented to our clinic with complaints of dyspnea for seven days. Arterial blood pressure and heart rate were 100/60 mm Hg and 116 bpm respectively. Electrocardiography showed S1-Q3-T3 pattern with mild sinus tachycardia. Two-dimensional transthoracic echocardiography (TTE) revealed a giant, highly mobile thrombus in the right atrium prolapsing into right ventricle through the tricuspid orifice during diastole (Fig. 1, Video 1.