What is the clinical evidence from this study?

Study design: Case Report. Population: Atrial fibrillation and severe mitral stenosis (n=1). Intervention: Warfarin. Primary outcome: Development of left atrial thrombus.

January 20, 2024CureusOpen Access

Large Left Atrial Thrombus in a Patient With Severe Mitral Stenosis and Atrial Fibrillation Despite Anticoagulant Therapy: A Case Report

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Key result

A large left atrial thrombus developed in an 82-year-old woman with severe mitral stenosis and atrial fibrillation despite maintaining a therapeutic INR on warfarin therapy.

Design

Case report

Authors

SNSilvio NoccoOspedaliero Sirai LCLaura ConcasFederazione Medico Sportiva Italiana MFMarco FeiOspedaliero Sirai

Discussion

Member takes

Implication

May support adjunctive LMWH in refractory LA thrombus; leaves open prospective trials in mitral stenosis with AF.

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Population

An 82-year-old female with permanent atrial fibrillation, severe mitral stenosis, and left atrial dilatation who developed a large left atrial thrombus despite adequate warfarin therapy.

Intervention

Enoxaparin 5,000 IU twice daily subcutaneously, followed by warfarin with a higher target INR (3-3.5).

Outcome

Reduction in thrombus size on echocardiographysurrogate

This case highlights that large left atrial thrombi can form in patients with severe mitral stenosis and atrial fibrillation despite adequate vitamin K antagonist therapy, emphasizing the need for regular echocardiographic monitoring.

Limitations

Transoesophageal echocardiography was not performed due to the patient's poor general condition.

Cite This Study

Nocco et al. (2024) conducted a case report in Atrial fibrillation and severe mitral stenosis (n=1). Warfarin was evaluated on Development of left atrial thrombus. A large left atrial thrombus developed in an 82-year-old woman with severe mitral stenosis and atrial fibrillation despite maintaining a therapeutic INR on warfarin therapy.

synapsesocial.com/papers/6a98786cea81e9c77df5ab9c https://doi.org/10.7759/cureus.52634

View Full Paper

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January 20, 2024CureusOpen Access

Large Left Atrial Thrombus in a Patient With Severe Mitral Stenosis and Atrial Fibrillation Despite Anticoagulant Therapy: A Case Report

View Full Paper

Ask AI

Bookmark

Key result

A large left atrial thrombus developed in an 82-year-old woman with severe mitral stenosis and atrial fibrillation despite maintaining a therapeutic INR on warfarin therapy.

Design

Case report

Authors

SNSilvio NoccoOspedaliero Sirai LCLaura ConcasFederazione Medico Sportiva Italiana MFMarco FeiOspedaliero Sirai

Discussion

Member takes

Implication

May support adjunctive LMWH in refractory LA thrombus; leaves open prospective trials in mitral stenosis with AF.

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Population

An 82-year-old female with permanent atrial fibrillation, severe mitral stenosis, and left atrial dilatation who developed a large left atrial thrombus despite adequate warfarin therapy.

Intervention

Enoxaparin 5,000 IU twice daily subcutaneously, followed by warfarin with a higher target INR (3-3.5).

Outcome

Reduction in thrombus size on echocardiographysurrogate

Limitations

Transoesophageal echocardiography was not performed due to the patient's poor general condition.

Cite This Study

synapsesocial.com/papers/6a98786cea81e9c77df5ab9c https://doi.org/10.7759/cureus.52634

Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

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