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Right atrial thrombus in a patient with COVID-19 pneumonia: a case report
BACKGROUND: Significant 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...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7499658/ https://www.ncbi.nlm.nih.gov/pubmed/33089061 http://dx.doi.org/10.1093/ehjcr/ytaa296 |
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author | Shamsah, Mohammed A Bitar, Zouheir Ibrahim Alfoudri, Huda |
author_facet | Shamsah, Mohammed A Bitar, Zouheir Ibrahim Alfoudri, Huda |
author_sort | Shamsah, Mohammed A |
collection | PubMed |
description | BACKGROUND: Significant 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 SUMMARY: We 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. DISCUSSION: Critical 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. |
format | Online Article Text |
id | pubmed-7499658 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-74996582020-09-21 Right atrial thrombus in a patient with COVID-19 pneumonia: a case report Shamsah, Mohammed A Bitar, Zouheir Ibrahim Alfoudri, Huda Eur Heart J Case Rep Case Reports BACKGROUND: Significant 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 SUMMARY: We 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. DISCUSSION: Critical 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. Oxford University Press 2020-09-04 /pmc/articles/PMC7499658/ /pubmed/33089061 http://dx.doi.org/10.1093/ehjcr/ytaa296 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Case Reports Shamsah, Mohammed A Bitar, Zouheir Ibrahim Alfoudri, Huda Right atrial thrombus in a patient with COVID-19 pneumonia: a case report |
title | Right atrial thrombus in a patient with COVID-19 pneumonia: a case report |
title_full | Right atrial thrombus in a patient with COVID-19 pneumonia: a case report |
title_fullStr | Right atrial thrombus in a patient with COVID-19 pneumonia: a case report |
title_full_unstemmed | Right atrial thrombus in a patient with COVID-19 pneumonia: a case report |
title_short | Right atrial thrombus in a patient with COVID-19 pneumonia: a case report |
title_sort | right atrial thrombus in a patient with covid-19 pneumonia: a case report |
topic | Case Reports |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7499658/ https://www.ncbi.nlm.nih.gov/pubmed/33089061 http://dx.doi.org/10.1093/ehjcr/ytaa296 |
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