Key result
COVID-19 infection was associated with the acute formation of large thrombi in both the left and right atrial appendages in a 66-year-old man with underlying predisposing factors.
Why the study?
Multiple intra-atrial thrombi are rarely found without prosthetic valves, intra-cardiac devices, structural connections like foramen ovale, or thrombophilia.
Case Report (n=1)
No
COVID-19 infection may act as a novel trigger for rapid and unusual thrombosis, such as simultaneous large thrombi in both atrial appendages, even in patients with pre-existing risk factors.
Alerts clinicians to rare bilateral thrombi in apical HCM with AF; leaves open thrombotic risk assessment in prospective studies.
BACKGROUND: Multiple intra-atrial thrombi are found rarely except in the presence of prosthetic valves, intra-cardiac devices, structural connections like foramen ovale and thrombophilia. CASE PRESENTATION: We reported acute thrombosis formation in right and left atrial appendages of a 66-year old man admitted due to progressive dyspnea since 7 days earlier. He had a history of prior laryngeal Squamous Cell Carcinoma, apical hypertrophic cardiomyopathy (HCM), and atrial fibrillation (AF). Infection with COVID-19 was confirmed thereafter. Cardiac Magnetic Resonance Imaging (CMR) suggested the diagnosis of atrial clot superior to neoplasm. After surgical removal of the thrombi, symptoms as well as imaging features of pneumonia were resolved. CONCLUSIONS: We should focus on different presentations and complications of systemic inflammation especially in the setting of COVID-19 infection. Although risk factors of thrombosis are present in some of these patients, rapid progression as well as unusual types of involvement may indicate to a new trigger.
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Ghodsi et al. (2021) conducted a case report in COVID-19 infection with atrial thrombi (n=1). COVID-19 infection was evaluated on Thrombus formation in left and right atrial appendages. COVID-19 infection was associated with the acute formation of large thrombi in both the left and right atrial appendages in a 66-year-old man with underlying predisposing factors.
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