A Case of Deep Vein Thrombosis Complicated by Right Atrial Clot-in-Transit and Pulmonary Embolism in an Alcoholic Male.

This report presents the case of a 62-year-old male with a history of chronic alcohol abuse who developed deep vein thrombosis (DVT) complicated by extensive bilateral pulmonary embolism (PE) and a right atrial thrombus. The presence of a right atrial thrombus in conjunction with PE and DVT is a rare and serious clinical presentation, often associated with a high thrombotic burden and increased risk of mortality. The patient initially presented with worsening shortness of breath following an occupational injury that resulted in a left heel laceration, subsequently leading to a significant thromboembolic event. The clinical course was marked by syncope and hemodynamic instability, necessitating urgent intervention. Initial management involved anticoagulation; however, due to the patient's critical condition and hemodynamic instability, urgent mechanical aspiration thrombectomy was performed, successfully removing the thrombi and stabilizing the patient. This case stresses the multifactorial nature of thromboembolism, highlighting the interplay between trauma, chronic alcohol abuse, and thrombus formation. The report also emphasizes the importance of considering lifestyle and occupational factors in the risk assessment and management of thromboembolic events, while also illustrating the efficacy of advanced interventional techniques in treating complex cases of PE with intracardiac thrombi.