Key result
Worsening dyspnea despite warfarin reveals fibrillatory LAA with tip clot in RHD and AFib.
This case highlights the imaging finding of a fibrillatory left atrial appendage with a tip clot in a patient with rheumatic heart disease and atrial fibrillation despite anticoagulation.
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Alerts to LAA thrombus risk on warfarin in rheumatic AF; leaves open optimal prevention strategies.
A 54-year-old woman with rheumatic heart disease and percutaneous transvenous mitral commissurotomy 15 years prior presented with worsening dyspnea for a duration of 3 months. The patient had been on warfarin for atrial fibrillation, beta blockers, and diuretics over the last 3 months from our outpatient department.
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Rathinasamy et al. (2026) studied this question. A 54-year-old woman with rheumatic heart disease and atrial fibrillation presented with worsening dyspnea despite warfarin therapy, revealing a fibrillatory left atrial appendage with tip clot.
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