Dataset Information

Multiple biventricular thrombi in a patient with alcoholic cardiomyopathy and COVID-19: A tragic association in a deadly pandemic.

ABSTRACT: 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.

SUBMITTER: Jariwala P

PROVIDER: S-EPMC8995302 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Multiple biventricular thrombi in a patient with alcoholic cardiomyopathy and COVID-19: A tragic association in a deadly pandemic.

Jariwala Pankaj P Jadhav Kartik K Khetan Saket S

Journal of cardiology cases 20220411 2

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 in ...[more]

PMID: 35432633

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Project description:Arrhythmogenic cardiomyopathy (ACM) is a genetic disease characterized by fibro-fatty myocardial replacement and is clinically associated with malignant ventricular arrhythmias and sudden cardiac death. It presents a major diagnostic and therapeutic challenge due to its complex clinical presentation and multiparametric diagnostic scoring system that includes structural, histological, and electrocardiographic data. A 57-year-old man with a history of palpitation and premature ventricular contractions (PVC) experienced syncope and sustained ventricular tachycardia at a rate of 213 bpm, which was successfully rescued by synchronized cardioversion. Multiple ventricular aneurysms were found in the right ventricular free wall and the left ventricular apical regions, as well as mild biventricular systolic dysfunction, according to echocardiography and high-frequency ultrasound. The genetic analysis revealed the following desmoplakin genes, chr6-7585274-7585275, NM_004415, exon24, and c.7780delT (p.S2594Pfs*9), a heterozygous and likely pathogenic mutation, as the mutation sites in the patient and his 24-year-old daughter. During the 21-month follow-up, the patient did not experience syncope or pre-syncope symptoms while on β-blocker (bisoprolol) therapy. Among the multimodality imaging techniques of the ACM, late gadolinium enhancement on cardiac magnetic resonance (CMR) is accepted as a more objective indicator of myocardial fibrosis. Left ventricular systolic dysfunction, fibrosis on CMR, and frequent PVC are the primary and most sensitive clinical signs of desmoplakin cardiomyopathy. However, echocardiography continues to be the most commonly used imaging modality for assessing focal ventricular movement and structural abnormalities. The pathological characteristics of arrhythmogenic cardiomyopathy of the right ventricular anterior free wall and apical regions near the transducer can be better shown using high-frequency linear ultrasound with a higher resolution.

Dataset Information

Multiple biventricular thrombi in a patient with alcoholic cardiomyopathy and COVID-19: A tragic association in a deadly pandemic.

Learning objectives

Publications

Multiple biventricular thrombi in a patient with alcoholic cardiomyopathy and COVID-19: A tragic association in a deadly pandemic.

Similar Datasets

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