a step-by-step fight for life in a young woman with high-risk pulmonary embolism and bilateral renal artery occlusion

Right heart thrombus-in-transit is rare in the context of acute pulmonary embolism (APE) and is associated with high mortality and morbidity. Transthoracic echocardiography (TTE) should always be performed in patients presenting dyspnea, chest pain, and hemodynamic instability. This case illustrates the importance of multimodality imaging in managing difficult cases with APE and right heart thrombus in transit, as well as the complications of this condition. A therapeutic approach should be decided on by multidisciplinary teams. (author)