Key result
Warfarin therapy resulted in complete resolution of extensive intracardiac thrombi after 4 weeks in a patient with heart failure and hepatic congestion.
Why the study?
Does warfarin therapy resolve extensive intracardiac thrombi in a patient with heart failure and hepatic congestion?
Case Report (n=1)
Does warfarin therapy resolve extensive intracardiac thrombi in a patient with heart failure and hepatic congestion?
Warfarin therapy successfully resolved extensive intracardiac thrombi in a patient with heart failure and hepatic congestion, highlighting the utility of cardiac MRI for diagnosis and monitoring.
BACKGROUND: Left ventricular (LV) thrombi is a complication associated with anterior ST-elevation myocardial infarction, dilated cardiomyopathies, or LV aneurysms. Right sided intracardiac thrombi may be associated with other prothrombotic causes. CASE SUMMARY: A 66-year-old man admitted with congestive heart failure was found to have extensive intracardiac masses on transthoracic echocardiography and cardiac magnetic resonance imaging (MRI). This occurred in the absence of a recent myocardial infarction. During his hospital stay, he was found to have deranged liver enzymes and coagulation profile due to hepatic congestion. The patient was presumed to have intracardiac thrombi and was treated with warfarin therapy. There was complete resolution of the masses on repeat cardiac MRI after 4 weeks of treatment, confirming the diagnosis. DISCUSSION: Cardiac MRI is useful in the diagnosis of intracardiac thrombi. Clinicians should appreciate the prothrombotic risks associated with liver disease, despite the inability of standard coagulation tests to quantify this risk.
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Wong et al. (2018) conducted a case report in Congestive heart failure and hepatic congestion with intracardiac thrombi (n=1). Warfarin therapy was evaluated on Resolution of intracardiac masses. Warfarin therapy resulted in complete resolution of extensive intracardiac thrombi after 4 weeks in a patient with heart failure and hepatic congestion.
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