Project description:The diagnosis of an apical left ventricular thrombus in the setting of a dilated cardiomyopathy is not uncommon. However, biventricular apical thrombi in this setting is unusual. We present a case of a 67-year-old man who was admitted with new onset heart failure with biventricular apical thrombus formation in the absence of a hypercoagulable state.
Project description:IntroductionCoronavirus 2019 (COVID-19) can cause cardiovascular manifestations including myocardial injury and thromboembolic events.Case presentationHere, we report a case of a 27-year-old female with dilated cardiomyopathy, right atrial and biventricular thrombi infected with COVID-19.DiscussionThere are several complex coagulation abnormalities in COVID-19 patients that have been suggested to create a hypercoagulable state. Evidence have shown that endothelial injury potentially leading to thromboembolic events is caused by direct invasion of endothelial cell by SARS-CoV-2 and complement activation contributed by the virus spike protein.ConclusionDCM can be complicated by atrial and biventricular thrombi due to coagulation abnormalities that are likely to persist after recovery from COVID-19. Thus, long-term careful monitoring of cardiac function is necessary after recovery of COVID-19.
Project description:COVID-19 is a novel disease with multisystem involvement, but most patients have pulmonary and cardiovascular involvement in the acute stages. The cardiovascular impact of acute COVID-19 is well recognized and ranges from myocarditis, arrhythmias, and thrombotic occlusion of coronary arteries to spontaneous coronary artery dissection and microthrombi in small coronary vessels on autopsy. We report a case of a 37-year-old man who recovered from mild COVID-19 only to present a few weeks later with devastating cardiovascular involvement that included severe left ventricular impairment resulting from nonischemic cardiomyopathy, multiple left ventricular thrombi, and embolic stroke.
Project description:Biventricular thrombi secondary to anterior myocardial infarction is very rare. We present a patient with giant biventricular thrombi subsequent to an old anterior wall myocardial infarction, and devastating consequences, including acute pulmonary artery and femoral artery embolism. We introduce a unique case report with demonstrative and illustrative images.
Project description:IntroductionIt is not clear whether patients with sinus rhythm and reduced left ventricular function should be treated with anticoagulation therapy during or after treatment for heart failure.Case presentationA 67-year-old Japanese man was hospitalized at our institution with heart failure due to dilated cardiomyopathy. On day after discharge, he developed cerebral infarction and showed persistence of multiple left ventricular thrombi. His paralysis completely improved at 2 days after edaravone and heparin administration; however, his left visual field defect persisted.ConclusionPatients in sinus rhythm with reduced left ventricular function might benefit from anticoagulation therapy during treatment for heart failure.
Project description:As a primary cause, intracardiac thrombi are seen in a variety of cardiac conditions such as acute anterior myocardial infarctions and dilated cardiomyopathy. However, there are secondary predisposing conditions that increase the risk of clot formation in normally functioning ventricles. Migration or embolization of thrombus produced elsewhere, such as pulmonary thrombo-embolism, may occur at times. However, the current coronavirus disease 2019 (COVID-19) pandemic has resulted in a variety of intracardiac or extracardiac thrombi formations due to systemic inflammation and activation of the clotting system. We present a unique and rare case in association with alcoholic dilated cardiomyopathy and COVID-19, which resulted in the development of multiple biventricular thrombi.Learning objectives•Significant systolic dysfunction is unusual, especially in people with prolonged alcoholism.•The hypercoagulable condition of coronavirus disease 2019 (COVID-19), combined with myocardial damage secondary to alcohol, can result in extensive intracardiac thrombosis.•Thrombotic manifestations in COVID-19 are associated with a high mortality rate.