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.
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.
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DOI：
10.1186/s40981-020-00390-z
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发表时间：
2020-10-24
影响因子：
0.9
通讯作者：
Komori M
中科院分区：
文献类型：
--
作者：
Okamura K;Kodaka M;Ichikawa J;Ando K;Komori M
目前，尽管在住院几天内提供了肝素化，但很少报告发生左心房血栓，无房颤（AF）和二尖瓣狭窄（MS）。一名71岁女性出现胸部不适和呼吸困难。经胸超声心动图（TTE）检查显示ST段抬高伴窦性心律、充血性心力衰竭和中度二尖瓣返流（MR）。给予利尿剂、冠状血管扩张剂和普通肝素（15，000单位/天）。住院后4天，她的C反应蛋白水平升高;因此，重复TTE，显示左心耳血栓，这可能是由于抗凝血酶低（49%）而受到肝素抵抗的影响。第5天，患者接受了血栓紧急清除术、二尖瓣置换术和冠状动脉搭桥术。患者可以表现出低左心室收缩力，甚至窦性心律没有MS。因此，TTE和随后的凝血试验，包括抗凝血酶必须进行，以防止血栓。
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. 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. 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.
影响因子：
6.7
作者：
Lip, Gregory Y. H.;Ponikowski, Piotr;Lane, Deirdre A.
通讯作者：
Lane, Deirdre A.
影响因子：
8.3
作者：
LEE, RJ;BARTZOKIS, T;SCHNITTGER, I
通讯作者：
SCHNITTGER, I