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[The diagnosis and treatment of mobile thrombi in the right heart chambers during pulmonary embolism. A report of 3 cases].

We report the clinical, echocardiographic and therapeutic aspects of three cases of right cardiac migrant thromboembolus in pulmonary embolism. The 2D echo was always evocative of freely floating migrant thromboembolus in the right cardiac chambers. Medical therapy consisted of tissue plasminogen activator in two patients, and only calcic heparin and salicylic acid in one patient because of contraindications for a more aggressive therapy. Progressive reduction of thromboembolus until its disappearance was observed by echo 2D in two patients some hours after rt-PA administration, in one patient seven days after therapy with calcic heparin and salicylic acid. Echo 2D may be important test in diagnosis pulmonary embolism when perfusion lung (extremely sensitive but non specific test) or pulmonary angiography (the most accurate test) are not available at pulmonary angiography (the most accurate test) are not available at hospital and patient cannot be transferred for his critical illness. Fibrinolytic therapy seems extremely effective if administered early.