Intracardiac thrombosis diagnosed by echocardiography in childhood: predisposing and etiological factors

Özkutlu, Süheyla; Özbarlas, Nazan; Özme, Şencan; Saraçlar, Muhsin; Göğüş, S; Demircin, Metin

doi:10.1016/0167-5273(93)90008-5

Cited by 23 publications

(16 citation statements)

References 17 publications

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“…An underlying risk factor or a genetic susceptibility must be present to start a thrombotic event [10,11,12]. The most common location for intracardiac thrombus is the rightsided chambers of the heart.…”

Section: Discussionmentioning

confidence: 99%

Intracardiac Thrombus in Children: The Fine Equilibrium Between the Risk and the Benefit

Çetin¹,

Ekici²,

Ünal

et al. 2014

Pediatric Hematology and Oncology

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The medical records of 16 patients diagnosed as intracardiac thrombus were searched. The size, location and outcome of thrombus together with demographic data of patients were assessed. The median age of the patients was 2.2 years. Six patients were newborn and two patients were infant. The median size of thrombus was 9 mm. The localization was right atrium in seven, right ventricle in five, left ventricle in one, pulmonary artery in one, and superior vena cava in two patients. There was prematurity in five, ciyanotic congenital heart disease in one, blood culture positivity in three, malignancy in four, nephrotic syndrome in one, indwelling catheters in 10, and acquired or genetic thrombophilia in six patients as risk factors. In the treatment, the first choice was tissue plasminogen activator in two patients, heparin infusion in one patient and low molecular weight heparin in remaining 12 patients. In nine patients, therapy included parenteral antimicrobials together with anticoagulants. The result was complete resolution in 15 patients and in one patient thrombus was surgically removed. The median time was 16 (2-70) days for 50% resolution and 26 (3-93) days for complete resolution. There was a statistically significant (P = .027 and r = 0.5) correlation between the size and the complete resolution time. There was no anticoagulant therapy related major complication. In patients with intracardiac thrombus, selection of anticoagulant therapy may decrease the risk of complications. Surgery is rarely required and thrombolytics are not usually necessary for resolution of thrombus.

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Section: Discussionmentioning

confidence: 99%

Intracardiac Thrombus in Children: The Fine Equilibrium Between the Risk and the Benefit

Çetin¹,

Ekici²,

Ünal

et al. 2014

Pediatric Hematology and Oncology

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“…It is unusual to develop intraventricular thrombus with a normal contractility in absence of cardiomyopathy with either global or regional left ventricular dysfunction. In this regard, Özkutlu et al demonstrated that three out of eleven patients with intracardiac thrombus and otherwise normal heart had protein C deficiency [14]. Our patient did not have any cardiomyopathy or left ventricular dysfunction.…”

Section: Discussionsupporting

confidence: 47%

Large Left Ventricular Thrombus in a Patient with Systemic and Venous Thromboembolism Secondary to Protein C and S Deficiency

Pahuja

Ainapurapu

Abidov

2017

Case Reports in Cardiology

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58-year-old Hispanic female presented with an altered mental status. A CT scan of the head demonstrated multiple scattered infarcts and a large right temporal lobe infarct. We also diagnosed the patient with right popliteal and femoral vein thrombosis, bilateral pulmonary embolism, and a transient right radial artery occlusion. Her 12-lead EKG showed lateral ST elevation. Emergent coronary angiogram revealed normal coronaries. Echocardiogram demonstrated a large mobile mass attached to the anterolateral free wall with overall normal contractility of the left ventricle. The patient underwent surgical embolectomy to prevent further systemic embolization. Coagulability workup returned positive for protein C and S deficiency. The patient did well after surgery. Following her surgery, we initiated chronic oral anticoagulation. The presentation with intracardiac thrombus in a normal heart should raise a concern of a probable thrombophilia.

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“…Other studies have been reviews of patients presenting with intracardiac thrombus, which have included some patients with cardiomyopathy. 592,593 Data on management and outcomes are derived from case reports and small case series. A recent pediatric review of intracardiac thrombus with heterogeneous origins showed resolution with medical therapy including heparin, warfarin, and aspirin in 63% (55% for those with dilated cardiomyopathy), sometimes used in combination.…”

Section: Anticoagulation For Dilated and Inflammatory Cardiomyopathymentioning

confidence: 99%

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

Giglia¹,

Massicotte²,

Tweddell³

et al. 2013

Circulation

269

245

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Intracardiac thrombosis diagnosed by echocardiography in childhood: predisposing and etiological factors

Cited by 23 publications

References 17 publications

Intracardiac Thrombus in Children: The Fine Equilibrium Between the Risk and the Benefit

Intracardiac Thrombus in Children: The Fine Equilibrium Between the Risk and the Benefit

Large Left Ventricular Thrombus in a Patient with Systemic and Venous Thromboembolism Secondary to Protein C and S Deficiency

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

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