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Disseminated intracardiac thrombosis: a rare manifestation of antiphospholipid syndrome.

Abanador-Kamper N, Wolfertz J, Kamper L, Haage P, Seyfarth M - Eur Heart J Cardiovasc Imaging (2012)

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Witten/Herdecke University, Helios Medical Centre Wuppertal, Wuppertal, Germany. nadine.abanador@helios-kliniken.de

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He presented with dyspnoea and recurrent fever of unknown origin... Infection parameters were found to be positive (C-reactive protein 24 mg/dL, reference <0.5 mg/dL; white blood cells 12 900/nL) and platelet count was low (16 000/µL)... Transthoracic echocardiography showed a complex and irregular mass adherent to the endocardial surface of the right outflow tract and smaller floating structures of the right atrium (RA) and right ventricle (RV)... Transoesophageal echocardiogram certified three masses: one was connected with the RA septum near the vena cava superior (Panel A), hyperechogenic and extending to the RV in diastole; another one was attached to the free RV wall; and the third one was adherent to the wall of the RV outflow tract and intermittently prolapsed through the pulmonary valve... A cardiac computed tomography confirmed the pseudotumours with partial calcification and the absence of contrast enhancement (Panel B)... Hereditary thrombophilia and heparin-induced thrombocytopenia as well as rheumatological and serological testings were negative... Cardiothoracic surgery was then performed due to the obstruction of RV outflow tract and to prevent further embolic complications... Surgical resection confirmed the thrombotic material with focal regions of calcification (Panel C)... The diagnosis of antiphospholipid syndrome was confirmed by an anticardiolipin antibody test... Despite of continuous effective anticoagulation therapy, the patient died 2 weeks after surgical resection... Transoesophageal echocardiography showing the right (RA) and left atrium (LA)... Intracardiac mass with partial calcification was detected in the RA... Disseminated intracardiac thrombosis (asterisk) with extensive intracardiac thrombosis in the right atrium (RA) and right ventricular (RV) apex and destruction of the tricuspid valve with disseminated thrombosis.

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Disseminated intracardiac thrombosis: a rare manifestation of antiphospholipid syndrome.

Abanador-Kamper N, Wolfertz J, Kamper L, Haage P, Seyfarth M - Eur Heart J Cardiovasc Imaging (2012)

© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3351131&req=5

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Witten/Herdecke University, Helios Medical Centre Wuppertal, Wuppertal, Germany. nadine.abanador@helios-kliniken.de

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

He presented with dyspnoea and recurrent fever of unknown origin... Infection parameters were found to be positive (C-reactive protein 24 mg/dL, reference <0.5 mg/dL; white blood cells 12 900/nL) and platelet count was low (16 000/µL)... Transthoracic echocardiography showed a complex and irregular mass adherent to the endocardial surface of the right outflow tract and smaller floating structures of the right atrium (RA) and right ventricle (RV)... Transoesophageal echocardiogram certified three masses: one was connected with the RA septum near the vena cava superior (Panel A), hyperechogenic and extending to the RV in diastole; another one was attached to the free RV wall; and the third one was adherent to the wall of the RV outflow tract and intermittently prolapsed through the pulmonary valve... A cardiac computed tomography confirmed the pseudotumours with partial calcification and the absence of contrast enhancement (Panel B)... Hereditary thrombophilia and heparin-induced thrombocytopenia as well as rheumatological and serological testings were negative... Cardiothoracic surgery was then performed due to the obstruction of RV outflow tract and to prevent further embolic complications... Surgical resection confirmed the thrombotic material with focal regions of calcification (Panel C)... The diagnosis of antiphospholipid syndrome was confirmed by an anticardiolipin antibody test... Despite of continuous effective anticoagulation therapy, the patient died 2 weeks after surgical resection... Transoesophageal echocardiography showing the right (RA) and left atrium (LA)... Intracardiac mass with partial calcification was detected in the RA... Disseminated intracardiac thrombosis (asterisk) with extensive intracardiac thrombosis in the right atrium (RA) and right ventricular (RV) apex and destruction of the tricuspid valve with disseminated thrombosis.

Show MeSH