Project description:BackgroundSignificant coagulopathy and hyperinflammation are found in patients with coronavirus disease 2019 (COVID-19). Expert consensus has recommended prophylactic anticoagulation in COVID-19 patients due to the risk of thrombo-embolism. However, the use of therapeutic anticoagulation in these patients is still a matter of debate.Case summaryWe describe a patient with COVID-19 pneumonia and a clinical hyperinflammatory state. He developed early respiratory depression and required ventilation, and he subsequently developed haemodynamic instability. Point-of-care echocardiography demonstrated a right atrial thrombus and right ventricular dysfunction suggestive of acute massive pulmonary embolism. He was managed with veno-arterial extracorporeal membrane oxygenation and local thrombolysis.DiscussionCritical cases of COVID-19 pneumonia are associated with hypercoagulation, and these patients should be monitored closely for complications. Therapeutic anticoagulation may play a role in the management and prevention of thrombo-embolism.

| S-EPMC7499658 | biostudies-literature

[Thrombus in transit in patient with COVID-19 pneumonia].

Project description: Not available

| S-EPMC7315993 | biostudies-literature

Thrombus Formation in the Right Atrium after Surgical Closure of Atrial Septal Defect.

Project description:Atrial septal defect is the most common congenital lesion in adults following bicuspid aortic valve. There are two closure strategies as follows: one surgical and the other percutaneous. Various complications such as atrial arrhythmias and development of thrombus have been reported after surgical closure. Herein, we present a case of right atrial thrombi formed at different localizations in the right atrium in a patient who was asymptomatic and diagnosed late.

| S-EPMC6341848 | biostudies-literature

Ascending aortic dissecting aneurysm with rupture into the right atrium associated with COVID-19.

Project description: Not available

| S-EPMC9196298 | biostudies-literature

Pulmonary embolism with floating thrombus in right atrium complicated by ischemic stroke during systemic fibrinolysis.

Project description:Acute pulmonary embolism (PE) is the third most common cause of cardiovascular death in Europe. The presence of a floating thrombus in the right sections, is a life-threatening condition in which the most appropriate treatment is not well established. The management of this setting is still uncertain, particularly in cases of thrombosis straddling the patent foramen ovale (PFO). The stratification and treatment of PE do not consider the presence of intracardiac floating thrombosis. We describe the case of a female, 69-years-old, presenting to the emergency department because of sudden onset of dyspnea and pre-syncope. An echocardiogram was performed, showing a massive floating thrombus both in the right and left atrium, passing through a PFO. The patient underwent systemic thrombolysis with alteplase. After 1 h of infusion, sudden onset of left facio-brachio-crural hemiplegia occurred. An urgent cerebral angiographic computed tomography was performed with evidence of acute occlusion of the right M1 branch treated with mechanical thrombectomy. The presence of intracardiac thrombosis in both right and left cardiac chambers with involvement of the fossa ovalis added a further level of management complexity. To date, no clear therapeutic strategies are recommended in these clinical settings.Learning objective•The presence of floating thrombosis in the right sections is a life-threatening condition and could be considered in the risk stratification of pulmonary embolism•The presence of intracardiac thrombosis straddling the foramen ovale is a condition that poses additional difficulties in choosing the correct therapeutic approach during massive pulmonary embolis.

| S-EPMC10287940 | biostudies-literature

Surgical Treatment of Hepatocellular Carcinoma with a Tumor Thrombus Invading the Right Atrium: A Case Report.

Project description:Up to 3% of all hepatocellular carcinomas (HCCs) present with a tumor thrombus (TT) in the inferior vena cava (IVC) and right atrium (RA). Extensive growth of HCC into the IVC and the RA is associated with a particularly poor prognosis. This clinical condition is related to a high risk of sudden death due to pulmonary embolism or acute heart failure. Therefore, a technically challenging treatment undergoing hepatectomy and cavo-atrial thrombectomy is necessary. We report a 61-year-old man presenting with right subcostal pain, progressive weakness, and periodic shortness of breath for 3 months. He was diagnosed with advanced HCC with a TT extending from the right hepatic vein into the IVC and RA. A multidisciplinary meeting with cardiovascular and hepatobiliary surgeons, oncologists, cardiologists, anesthesiologists, and radiologists was held to determine the best treatment approach. Initially, the patient underwent right hemihepatectomy. As follows, the cardiovascular stage using cardiopulmonary bypass was successfully performed, removing the TT from the RA and ICV. In the early postoperative period, the patient remained stable and was discharged on the 8th postoperative day. A morphological examination revealed grade 2/3 HCC, a clear cell variant with microvascular and macrovascular invasion. Immunohistochemical staining was positive for HEP-1, CD10, whereas negative for S100. The morphological and immunohistochemical results corresponded to HCC. The treatment of such patients requires the cooperation of various specialties. Although the approach of the surgery is extremely complex including specific technical support, as well as high perioperative risks, the result offers favorable clinical outcomes.

| S-EPMC10294241 | biostudies-literature

Right atrium crossover.

Project description: Not available

| S-EPMC10783639 | biostudies-literature

Is IL-6 the Right Target in COVID-19 Severe Pneumonia?

Project description: Not available

| S-EPMC7781133 | biostudies-literature

Pulmonary thromboembolism with multiple right heart mural thrombus in a patient with COVID-19.

Project description: Not available

| S-EPMC7587169 | biostudies-literature