Clot in Right Atrium

All: Had an echo cardiogram last Mon. They found a "Small clot" in RA; suspect it is on my PM lead. Due to location, not clearly resolved in images from EC.

Unknown origin; perhaps came about when my INR dropped to 1.4 for three days. Long story about that. Have an occasional A-Fib.

Have TEE this AM (Scheduled last night at quitting time at hosp - they could not get hold of me all day yesterday to sched it)

Already on Coumadin & last INR on Monday was 2.2 & hopefully crawling up toward the magic 2. 5 mark.

I know there are a bunch of you out there in PMC land who have had similar clots.

Any comments, suggestions, recommendations.
Leaving for hosp as soon as I close up here.
Don

14 Comments

keep moving

by ldebaugh - 2012-08-24 01:08:30

Sounds like all of you are on top of the clot issue. Thank goodness you know it and can deal with it. When you are home and recovering, I would look at exercise routine and be as active even if low key, every day.

As I say this, I need to get off the computer so that i can get moving too!
Sending best wishes!
M'Liz

Did they define "small"?

by cohara - 2012-08-24 02:08:43

Don,

I did a bit of pharma research for you. Coumadin will keep the clot from growing and prevent others from forming. It doesn't dissolve what is there. Did they catch it at such a small size that they feel it would be harmless if it developed wanderlust?

When you get the TEE results, they should have a clearer idea of the size. You might want to consider a conversation on how to dissolve what is already there or if it is even necessary to do so.

I am using my iPad and can't seem to be able to copy and paste a website. If you'd like a link, send me a message and I'll use my laptop to send it to you.

Take care,
Carol

Hi Don

by rosemarys granddaughter - 2012-08-24 03:08:35

Im sure they will get to the bottom of all of this asap. Keep everyone posted. wishing you only the best. Hurry back we all need your expert insight and interesting advice. BESSINGS Jane

Thank goodness

by cohara - 2012-08-24 04:08:38

I'm so glad that the clot was a no go. Sounds like quite an experience. Hope all is now back to normal, whatever that is.

Carol

Update: 2:21 PM.

by donr - 2012-08-24 04:08:59

Still a bit sleepy from prorpofol.

Bottom line - false alarm. Poor resolution apparently on chest side EC. For all of you who know the European meaning of TEE = Trans Eurpoean Express high speed train - that's exactly what I had - the TEE jammed down my throat.

I'd had one in 2002 & they tried 5 times to get the transducer down my throat unsuccessfully before sedating me. They had to sedate me & cardio worked it down there.. This time I warned them about that trouble & they lined up an anesthesiologist to come in & put me a bit deeper so they could get it down.

Unfortunately, it did not work, so after 10 min of trying, they brought me back & called in a Gastroenterologist - who they also had on call for just this sort of emergency & he put me back under for an endoscope exam to find out what was going wrong.

I'd had three X-ray real time exams of swallowing mechanism - last one this spring, where they found out what my swallowing problems were. MY ER Doc daughter had arranged it. WIFE, who sat by in waiting room got her on phone & our cardo & Daughter talked about me in DR. jargon about what they found in spring. All three Dr's talked & amazingly listened to Wife & me recount my tale.

When the anesthesiologist came in, as well as his nurse a few minutes later, I vetted them on their experience w/ PM's. They passed the oral exam. Very interestingly, neither of them objected one bit to being asked & discussed the issues very willingly.

At one point between procedures, I had no less than a dozen nurses & techs swimming around the room like a bunch of guppies in a tank at a pet store. It was a challenge to recall all the right names to go w/ the right people. At one point I was left alone w/ a young RN who was detailed to shepherd me through the process. She was harried & pretty panicked. I asked her if she was feeling rushed & she admitted tat she was. MY rejoinder to her was to relax - I was in no hurry & nothing would happen till I agreed to it, so take your time & do things right.

Gastro went in & found essentially nothing except a very tight esophagus & did some rudimentary stretching - which we had discussed beforehand as a possibility. Cardio went back in & very carefully got transducer down my throat & completed his exam. Found NO clots - either false alarm or IF it was there it has been absorbed already. Good news all the way around. After it was over, the hosp sent in their first team vampire from the lab to get some samples for culture studies to check for systemic infection.

On way home, Wife stopped & picked up a gallon of ice cream & a single spoon. Even I can not eat a gallon of the stuff by myself, but enjoyed it while I could before it froze my throat closed.

Thanks for the kind words & best wishes. Unfortunately, I did not see them till a few minutes ago AFTER the TEE blew its horn & went thundering through. (That's the European version - for folks across the Atlantic & the Shinkansen for those in Japan) In the FWIW Dept, my association w/ all of you really helped through this near panic episode. Bits & pieces picked up from many people made it organized confusion for me & helped me feel like I was in control of the entire process from start to finish, significantly reducing my stress/anxiety levels. Except, of course, while I was zonked, but I went into La-La land fully confident that I was then in the best hands possible. After all,I was the only one in the room who had a common objective through out the entire process.

BTW: this thing went down very suddenly. My cardio's office tried to get me yesterday - to do it yesterday, but I was out & did not make contact w/ them till very close to office closing time last night, & themn quite by accident. His head nurse, Bless her everloving heart, made all the arrangements just as the hosp was closing at 5 PM. There was little time to stew about the ramifications of what was happening.

There was one near panic - when I walked into the procedure room, the nurse asked if anyone had mentioned the word "Cardioversion." I told her in no certain terms that I was NOT there for one of those. When my Cardio's sidekick came in to do the test, I asked him about it, since he was standing in the door talking to their head nurse when she was putting the orders together last evening. He confirmed my statement that unless I had a bent for masochistic self flagellation & liked strong shocks to the heart, he had not planned on one.

For Tattoo Man (or is it IAN) - we did not want this being a case of getting sick over a weekend - the same rules on that apply here in the US as in the UK!

Well. back to harsh reality of daily living.

Don

Great news

by Janey L - 2012-08-24 05:08:03

Hi Don
SO glad you're ok! Hubby & I had quite a fright reading your post earlier & are both glad it was a false alarm. What a day you've had!! Glad you're back home.
Best wishes
Janey

Hi Don

by sue uk - 2012-08-24 06:08:23

Have Afib too & have had clots a few times and now my INR is kept 4 & above. The warfarin usually sorts them out for me & l hope it does the same for you.
Take care Don, & good luck!
Sue x

good luck Don

by ohiolaura - 2012-08-24 07:08:28

I dont know what the numbers mean,nor do I know what the INR is,but I pray you get answers,and a solution.
I know you'll keep us all posted,and you know all will be keeping you in their thoughts and prayers.
You are so helpful to so many like me,I know things will be ok for you,youre a good egg!
Good luck and God bless!

Thinking of you lots

by Janey L - 2012-08-24 11:08:23

Hi Don
Just read your post! I am so sorry to hear your news. I hope all goes well with the TEE & that they can sort this out quickly for you. You always help me SO much & I'm really sorry to hear you are going through this. Thinking of you very much.
Best wishes
Janey

Hi Don

by Jax - 2012-08-25 03:08:29

Glad to hear the good news. We've never met but I do read all yr posts. You he lp so many people including me.

Welcome back Don

by IAN MC - 2012-08-25 04:08:44

It's always good to return from La- La land. I have been there a few times but ,as a holiday destination , I don't find it at all memorable. Good place to relax though.

Cheers

Ian

thinking of you

by Hope - 2012-08-25 09:08:26

Hi! Just read your post. So glad your bad news turned to good news. Had a suspected clot once on my birthday. By the time ER was through with me, I definitely felt my age. Get some good rest and have a happy weekend. Hopeful Heart

Hope You're Better Soon!

by Many Blessings - 2012-08-25 12:08:38

Hi

I hope you are doing better and better every day! I will keep you in my prayers. Get well soon. We all need you here! :)



beware

by polrbear - 2012-08-25 12:08:57

Blood clots in the right atrium are classic for atrial fibrillation, but anything that interferes with the bloodflow (leads, scarring, and artificial valves are some obvious ones) has a risk for clots.

If a blood clot were in the legs (most common site for a deep vein thrombosis), they would consider an IVC filter (screen placed in your inferior vena cava) to help prevent this from moving somewhere. However, placing one in the pulmonary artery isn't so common (I'm not even sure if that's done, since the procedure has a risk of dislodging the clot).

Where does this lead? Well, the concern is less with the blood clot than what it can do if it moves around. They like to get stuck in small veins, such as your lungs. If that happens, it's called a pulmonary embolism. More specifically, a pulmonary thromboembolus (meaning a blood clot, as opposed to air or fat embolus). So, if they haven't already done so, they likely have you on a blood thinner (Pradaxa and Warfarin are two options) once the diagnosis is confirmed. This helps to keep the clot from getting bigger or a new one forming while your body slowly breaks down the current clot.

Pulmonary embolism can have sudden onset of chest pain and/or shortness of breath. If that happens, urgent treatment is needed. One option is clot-busting medications, which may make them nervous because it could dislodge the clot you already have. However, it may be possible to apply the clot-busting medications right where they're needed as a variation of an angiogram. Either way, until the clot resolves, extra self-awareness is a wise move.

Good luck!

Dustin

PS, it only showed two comments before I wrote this, then the spam filter reset. So, my info can be more of a "save until next time" thing now. Glad to hear the good news.

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