In a large cohort of 5,862 patients undergoing transesophageal echocardiography, left atrial cavity thrombosis was rare (0.38%) and primarily associated with valvular heart disease or thrombophilia.
Observational (n=5,862)
No
Extra-appendage atrial thrombosis is rare (0.41%) and typically associated with valvular heart disease or systemic hypercoagulable states.
Background: Atrial tachyarrhythmias are the main cause of atrial thrombosis, and are usually in the left appendage. The prevalence and causes of endocavitarian thrombosis have not been investigated in recent large-scale studies. Aim of our work was to describe the epidemiology, the clinical characteristics and predisposing factors of "extra-appendicular" atrial thrombosis and to report a systematic review of recent literature. Methods and Results: 5,862 consecutive adult patients referred to a transesophageal echocardiographic exam, were enrolled. A total of 175 subjects with Atrial Thrombosis were found with a prevalence of 2.98%; among those 22 was found in left (0.38%) and 2 in the right (0.03%) atrium. Among the 22 patients with left atrial thrombosis, 8 were associated with prosthetic valves, 4 with mitral stenosis and the remaining with hypercoagulative conditions (cancer, septic shock, eosinophilic pneumonia, cardiogenic shock and warfarin under-dosage in permanent atrial fibrillation and decompensated heart failure). Cancer was associated in one of the two patients with a right atrial clot. The review of the literature from 2000 to December 2019 revealed conflicting results of 48 case reports of atrial cavity thrombosis; pooling this data proved the rarity of extra-appendage thrombosis and confirmed its association with a valvular heart disease or a systemic hypercoagulable state. Conclusions: Atrial "extra-appendage" thrombosis is a rare condition usually associated to "valvular" atrial fibrillation (such as prosthetic valves and mitral stenosis). A minority, but significant, cases are secondary to a thrombophilic conditions. In absence of valvular heart disease an underlying condition should be sought.
Cresti et al. (2023) conducted an observational in Atrial thrombosis (n=5,862). Transesophageal echocardiography was evaluated on Prevalence of left atrial cavity thrombosis. In a large cohort of 5,862 patients undergoing transesophageal echocardiography, left atrial cavity thrombosis was rare (0.38%) and primarily associated with valvular heart disease or thrombophilia.