Left atrial thrombus formation within a few days of hospitalization in semi-acute ischemic heart disease despite no atrial fibrillation and mitral stenosis: a case report
Abstract Background Currently, the occurrence of left atrial thrombus despite the provision of heparinization within a few days of hospitalization without atrial fibrillation (AF) and mitral stenosis (MS) is rarely reported. Case presentation A 71-year-old woman presented with chest discomfort and d...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2020-10-01
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| Series: | JA Clinical Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40981-020-00390-z |
| _version_ | 1818324957054107648 |
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| author | Keiko Okamura Mitsuharu Kodaka Junko Ichikawa Kazuyoshi Ando Makiko Komori |
| author_facet | Keiko Okamura Mitsuharu Kodaka Junko Ichikawa Kazuyoshi Ando Makiko Komori |
| author_sort | Keiko Okamura |
| collection | DOAJ |
| description | Abstract Background Currently, the occurrence of left atrial thrombus despite the provision of heparinization within a few days of hospitalization without atrial fibrillation (AF) and mitral stenosis (MS) is rarely reported. Case presentation A 71-year-old woman presented with chest discomfort and dyspnea. Examination revealed ST elevation with sinus rhythm, congestive heart failure, and moderate mitral regurgitation (MR) by transthoracic echocardiography (TTE). Diuretics, a coronary vasodilator, and unfractionated heparin (15,000 units/day) were administered. Four days after hospitalization, her C-reactive protein level had increased; therefore, TTE was repeated, revealing a thrombus in the left atrial appendage, which was probably affected by heparin resistance because of low antithrombin (49%). On day 5, the patient underwent emergency removal of the thrombus, mitral valve replacement, and coronary artery bypass. Conclusion Patients can exhibit low left ventricular contractility, even sinus rhythm without MS. Thus, TTE and subsequent coagulation tests including antithrombin must be performed to prevent thrombus. |
| first_indexed | 2024-12-13T11:36:50Z |
| format | Article |
| id | doaj.art-22ddcb234f2146fb95d57e02d2b91c76 |
| institution | Directory Open Access Journal |
| issn | 2363-9024 |
| language | English |
| last_indexed | 2024-12-13T11:36:50Z |
| publishDate | 2020-10-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | JA Clinical Reports |
| spelling | doaj.art-22ddcb234f2146fb95d57e02d2b91c762022-12-21T23:47:45ZengSpringerOpenJA Clinical Reports2363-90242020-10-01611410.1186/s40981-020-00390-zLeft atrial thrombus formation within a few days of hospitalization in semi-acute ischemic heart disease despite no atrial fibrillation and mitral stenosis: a case reportKeiko Okamura0Mitsuharu Kodaka1Junko Ichikawa2Kazuyoshi Ando3Makiko Komori4Department of Anesthesiology & Intensive Care, Tokyo Women’s Medical University Medical Center EastDepartment of Anesthesiology & Intensive Care, Tokyo Women’s Medical University Medical Center EastDepartment of Anesthesiology & Intensive Care, Tokyo Women’s Medical University Medical Center EastDepartment of Anesthesiology & Intensive Care, Tokyo Women’s Medical University Medical Center EastDepartment of Anesthesiology & Intensive Care, Tokyo Women’s Medical University Medical Center EastAbstract Background Currently, the occurrence of left atrial thrombus despite the provision of heparinization within a few days of hospitalization without atrial fibrillation (AF) and mitral stenosis (MS) is rarely reported. Case presentation A 71-year-old woman presented with chest discomfort and dyspnea. Examination revealed ST elevation with sinus rhythm, congestive heart failure, and moderate mitral regurgitation (MR) by transthoracic echocardiography (TTE). Diuretics, a coronary vasodilator, and unfractionated heparin (15,000 units/day) were administered. Four days after hospitalization, her C-reactive protein level had increased; therefore, TTE was repeated, revealing a thrombus in the left atrial appendage, which was probably affected by heparin resistance because of low antithrombin (49%). On day 5, the patient underwent emergency removal of the thrombus, mitral valve replacement, and coronary artery bypass. Conclusion Patients can exhibit low left ventricular contractility, even sinus rhythm without MS. Thus, TTE and subsequent coagulation tests including antithrombin must be performed to prevent thrombus.http://link.springer.com/article/10.1186/s40981-020-00390-zLeft atrial thrombusSinus rhythmActivated partial thromboplastin timeHeparinization |
| spellingShingle | Keiko Okamura Mitsuharu Kodaka Junko Ichikawa Kazuyoshi Ando Makiko Komori Left atrial thrombus formation within a few days of hospitalization in semi-acute ischemic heart disease despite no atrial fibrillation and mitral stenosis: a case report JA Clinical Reports Left atrial thrombus Sinus rhythm Activated partial thromboplastin time Heparinization |
| title | Left atrial thrombus formation within a few days of hospitalization in semi-acute ischemic heart disease despite no atrial fibrillation and mitral stenosis: a case report |
| title_full | Left atrial thrombus formation within a few days of hospitalization in semi-acute ischemic heart disease despite no atrial fibrillation and mitral stenosis: a case report |
| title_fullStr | Left atrial thrombus formation within a few days of hospitalization in semi-acute ischemic heart disease despite no atrial fibrillation and mitral stenosis: a case report |
| title_full_unstemmed | Left atrial thrombus formation within a few days of hospitalization in semi-acute ischemic heart disease despite no atrial fibrillation and mitral stenosis: a case report |
| title_short | Left atrial thrombus formation within a few days of hospitalization in semi-acute ischemic heart disease despite no atrial fibrillation and mitral stenosis: a case report |
| title_sort | left atrial thrombus formation within a few days of hospitalization in semi acute ischemic heart disease despite no atrial fibrillation and mitral stenosis a case report |
| topic | Left atrial thrombus Sinus rhythm Activated partial thromboplastin time Heparinization |
| url | http://link.springer.com/article/10.1186/s40981-020-00390-z |
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