Lesson of the Week: Infected right atrial thrombus presenting as pulmonary embolism complicating central venous cannulationBMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7015.1288 (Published 11 November 1995) Cite this as: BMJ 1995;311:1288
- A Sajjad, registrara,
- P A Carey, registrar in cardiologyb,
- I R Arnold, consultant**a,
- S R Smith, consultanta
- aHorton General Hospital NHS Trust, Banbury, Oxon OX16 9AL
- bJohn Radcliffe Hospital, Headington, Oxford OX3 9DU
- Correspondence to: Dr Smith.
- Accepted 12 June 1995
Although the vast majority of pulmonary emboli arise from the iliac and femoral veins, we present a case that illustrates that other potential sources should be considered, especially when recurrent pulmonary emboli occur despite adequate anticoagulation.
A 64 year old man presented with fever and left sided pleuritic chest pain two weeks after a laminectomy. A ventilation perfusion scan showed multiple areas of ventilation-perfusion mismatch and he was anticoagulated. Subsequently he remained well until readmission four months later with sudden onset of chest pain, dyspnoea, fever, and rigors. A pansystolic murmur was noted on examination. …