tetano
Editor, Senior Moderator
Eur Heart J Case Rep
. 2020 Sep 4;4(FI1):1-4.
doi: 10.1093/ehjcr/ytaa296. eCollection 2020 Oct.
Right atrial thrombus in a patient with COVID-19 pneumonia: a case report
Mohammed A Shamsah[SUP] 1 [/SUP], Zouheir Ibrahim Bitar[SUP] 2 [/SUP], Huda Alfoudri[SUP] 1 [/SUP]
Affiliations
Abstract
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.
Keywords: COVID-19; Case report; Pneumonia; Pulmonary embolism; Thrombosis.
. 2020 Sep 4;4(FI1):1-4.
doi: 10.1093/ehjcr/ytaa296. eCollection 2020 Oct.
Right atrial thrombus in a patient with COVID-19 pneumonia: a case report
Mohammed A Shamsah[SUP] 1 [/SUP], Zouheir Ibrahim Bitar[SUP] 2 [/SUP], Huda Alfoudri[SUP] 1 [/SUP]
Affiliations
- PMID: 33089061
- PMCID: PMC7499658
- DOI: 10.1093/ehjcr/ytaa296
Abstract
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.
Keywords: COVID-19; Case report; Pneumonia; Pulmonary embolism; Thrombosis.