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A Case with Recurrent Free-Floating Ball Thrombi in Left Atrium

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ABSTRACT

Patient: female, 74"/> MedlinePlus

(A) Computed tomography (CT) scan of the heart showing free-floating thrombus with contrast (left panel, arrow). Because the ball thrombus was moving in the left atrium, it looked blurred by CT scan. The same thrombus detected by CT scan without contrast (right panel, arrow) showing its change of position in the left atrium. (B) Transthoracic echocardiography (TTE) showing that the ball thrombus (arrow) was moving freely.
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f1-amjcaserep-18-324: (A) Computed tomography (CT) scan of the heart showing free-floating thrombus with contrast (left panel, arrow). Because the ball thrombus was moving in the left atrium, it looked blurred by CT scan. The same thrombus detected by CT scan without contrast (right panel, arrow) showing its change of position in the left atrium. (B) Transthoracic echocardiography (TTE) showing that the ball thrombus (arrow) was moving freely.

Mentions: First, she experienced acute myocardial infarction with the culprit lesion in the right coronary artery. Percutaneous catheter intervention for this lesion was successful, and the peak level of CPK was 1317 IU/L. However, symptoms of heart failure were worsened 26 days after admission. A 40×30 mm free-floating ball thrombus was detected in the left atrium with TTE and computed tomography (CT) (Figure 1). Because it was diagnosed shortly after myocardial infarction, nonsurgical treatment was selected. Heparin (12,000 U/day) was started along with warfarin (2 mg). The thrombus disappeared in six days after intensive anticoagulant therapy. However, she developed systemic embolization, including left cerebellar infarction, splenic infarction, and right renal infarction. We speculated that these disorders were due to embolization of the resolving thrombi in the left atrium. She recovered with only mild sequelae and she was able to leave our hospital.


A Case with Recurrent Free-Floating Ball Thrombi in Left Atrium
(A) Computed tomography (CT) scan of the heart showing free-floating thrombus with contrast (left panel, arrow). Because the ball thrombus was moving in the left atrium, it looked blurred by CT scan. The same thrombus detected by CT scan without contrast (right panel, arrow) showing its change of position in the left atrium. (B) Transthoracic echocardiography (TTE) showing that the ball thrombus (arrow) was moving freely.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC5384620&req=5

f1-amjcaserep-18-324: (A) Computed tomography (CT) scan of the heart showing free-floating thrombus with contrast (left panel, arrow). Because the ball thrombus was moving in the left atrium, it looked blurred by CT scan. The same thrombus detected by CT scan without contrast (right panel, arrow) showing its change of position in the left atrium. (B) Transthoracic echocardiography (TTE) showing that the ball thrombus (arrow) was moving freely.
Mentions: First, she experienced acute myocardial infarction with the culprit lesion in the right coronary artery. Percutaneous catheter intervention for this lesion was successful, and the peak level of CPK was 1317 IU/L. However, symptoms of heart failure were worsened 26 days after admission. A 40×30 mm free-floating ball thrombus was detected in the left atrium with TTE and computed tomography (CT) (Figure 1). Because it was diagnosed shortly after myocardial infarction, nonsurgical treatment was selected. Heparin (12,000 U/day) was started along with warfarin (2 mg). The thrombus disappeared in six days after intensive anticoagulant therapy. However, she developed systemic embolization, including left cerebellar infarction, splenic infarction, and right renal infarction. We speculated that these disorders were due to embolization of the resolving thrombi in the left atrium. She recovered with only mild sequelae and she was able to leave our hospital.

View Article: PubMed Central - PubMed

ABSTRACT

Patient: female, 74"/> MedlinePlus