Thrombus at Ostium of Coronary Sinus Discovered during Evaluation for Cardiac Resynchronization Therapy

Abstract

A 50-year-old male patient with dilated cardiomyopathy was evaluated for cardiac resynchronization therapy. A transthoracic echocardiogram revealed a mass in close proximity to the coronary sinus ostium.The mass was considered to be a thrombus and found to have disappeared at the repeat echocardiogram performed following a month of anticoagulation therapy with warfarin. In this case report, we aim to emphasize the importance of coronary sinus imaging, especially during echocardiographic evaluation for cardiac asynchrony.

Spontaneous Coronary Sinus Thrombosis in a Patient With Pulmonary Embolism and No Prior Cardiac Instrumentation

“… Güvenç et al. 2012 6 Bloating 23 years Female Not mentioned Severe tricuspid regurgitation and congestive hepatopathy Aspirated during surgical TVR. Liu et al.…”

Pylephlebitis presenting as spontaneous coronary sinus thrombosis: a case report

“…Development of CST in the absence of instrumentation is even less common, and believed to be secondary to underlying prothrombotic states [ 1 – 3 ]. Despite this, the potential complications of CST can be catastrophic and include myocardial infarction, cardiac tamponade, sudden cardiac arrest, and death [ 1 , 4 – 6 ].…”

“…Thrombotic communication between the hepatic and cardiac venous systems has been demonstrated in the literature on one other occasion, but again was in the setting of instrumentation [ 5 ]. Both mechanical and pharmacologic treatment of this condition have been successful in the past, with the latter strategy proving effective in resolving our patient’s CS thrombus and hepatitis [ 4 , 9 ].…”