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Incidental diagnosis of a large cardiac thrombus swinging through an interatrial communication in a COVID-19 patient: Case report and literature review

INTRODUCTION: The hypercoagulability state induced by COVID-19 has been well established and various forms of subsequent thromboembolic events have been reported throughout literature including multiple cases of intracardiac thrombi, four of which in our center alone, this case being the fifth. CASE...

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Autores principales: Berrichi, Samia, Bouayed, Zakaria, Benbouchta, Karima, Kossir, Amine, Bkiyar, Houssam, Ismaili, Nabila, Ouafi, Noha El, Housni, Brahim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8524807/
https://www.ncbi.nlm.nih.gov/pubmed/34691408
http://dx.doi.org/10.1016/j.amsu.2021.102967
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author Berrichi, Samia
Bouayed, Zakaria
Benbouchta, Karima
Kossir, Amine
Bkiyar, Houssam
Ismaili, Nabila
Ouafi, Noha El
Housni, Brahim
author_facet Berrichi, Samia
Bouayed, Zakaria
Benbouchta, Karima
Kossir, Amine
Bkiyar, Houssam
Ismaili, Nabila
Ouafi, Noha El
Housni, Brahim
author_sort Berrichi, Samia
collection PubMed
description INTRODUCTION: The hypercoagulability state induced by COVID-19 has been well established and various forms of subsequent thromboembolic events have been reported throughout literature including multiple cases of intracardiac thrombi, four of which in our center alone, this case being the fifth. CASE REPORT: We report the case of a 38-year-old male with no prior cardiovascular history who -subsequently to a COVID-19 infection-developped a right atrial thrombosis associated to a pulmonary embolism, and in whom cardiography revealed an interatrial communication. Management relied upon curative doses of low molecular weight heparin (LMWH) with favourable outcome. DISCUSSION: In our discussion, we lay out the various physiopathological mechanisms incriminated throughout literature in the genesis of a hypercoagulability state distinctive of COVID-19, before highlighting the incidence of an interatrial communication (whether a Potent Foramen Ovale or Atrial Septal Defect) discovered in patients with COVID-19, and the potential paradoxical embolization risks they imply as well as reported cases. A mention of hemostatic parameters monitored was also warranted. Finally we discuss the guidelines in terms of prophylactic and therapeutic anticoagulation in hospitalized patients before discussing cardiac thrombosis's therapeutic options. CONCLUSION: Our case highlights various key points which could change the prognosis of COVID-19 patients, whether related to the underdiagnosis of interatrial abnormalities or with regards to the diagnosis to thromboembolic events, but also the indisputable place of anticoagulation in COVID-19 management.
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spelling pubmed-85248072021-10-20 Incidental diagnosis of a large cardiac thrombus swinging through an interatrial communication in a COVID-19 patient: Case report and literature review Berrichi, Samia Bouayed, Zakaria Benbouchta, Karima Kossir, Amine Bkiyar, Houssam Ismaili, Nabila Ouafi, Noha El Housni, Brahim Ann Med Surg (Lond) Case Report INTRODUCTION: The hypercoagulability state induced by COVID-19 has been well established and various forms of subsequent thromboembolic events have been reported throughout literature including multiple cases of intracardiac thrombi, four of which in our center alone, this case being the fifth. CASE REPORT: We report the case of a 38-year-old male with no prior cardiovascular history who -subsequently to a COVID-19 infection-developped a right atrial thrombosis associated to a pulmonary embolism, and in whom cardiography revealed an interatrial communication. Management relied upon curative doses of low molecular weight heparin (LMWH) with favourable outcome. DISCUSSION: In our discussion, we lay out the various physiopathological mechanisms incriminated throughout literature in the genesis of a hypercoagulability state distinctive of COVID-19, before highlighting the incidence of an interatrial communication (whether a Potent Foramen Ovale or Atrial Septal Defect) discovered in patients with COVID-19, and the potential paradoxical embolization risks they imply as well as reported cases. A mention of hemostatic parameters monitored was also warranted. Finally we discuss the guidelines in terms of prophylactic and therapeutic anticoagulation in hospitalized patients before discussing cardiac thrombosis's therapeutic options. CONCLUSION: Our case highlights various key points which could change the prognosis of COVID-19 patients, whether related to the underdiagnosis of interatrial abnormalities or with regards to the diagnosis to thromboembolic events, but also the indisputable place of anticoagulation in COVID-19 management. Elsevier 2021-10-19 /pmc/articles/PMC8524807/ /pubmed/34691408 http://dx.doi.org/10.1016/j.amsu.2021.102967 Text en © 2021 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Berrichi, Samia
Bouayed, Zakaria
Benbouchta, Karima
Kossir, Amine
Bkiyar, Houssam
Ismaili, Nabila
Ouafi, Noha El
Housni, Brahim
Incidental diagnosis of a large cardiac thrombus swinging through an interatrial communication in a COVID-19 patient: Case report and literature review
title Incidental diagnosis of a large cardiac thrombus swinging through an interatrial communication in a COVID-19 patient: Case report and literature review
title_full Incidental diagnosis of a large cardiac thrombus swinging through an interatrial communication in a COVID-19 patient: Case report and literature review
title_fullStr Incidental diagnosis of a large cardiac thrombus swinging through an interatrial communication in a COVID-19 patient: Case report and literature review
title_full_unstemmed Incidental diagnosis of a large cardiac thrombus swinging through an interatrial communication in a COVID-19 patient: Case report and literature review
title_short Incidental diagnosis of a large cardiac thrombus swinging through an interatrial communication in a COVID-19 patient: Case report and literature review
title_sort incidental diagnosis of a large cardiac thrombus swinging through an interatrial communication in a covid-19 patient: case report and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8524807/
https://www.ncbi.nlm.nih.gov/pubmed/34691408
http://dx.doi.org/10.1016/j.amsu.2021.102967
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