Left ventricular outflow tract thrombus in a patient with COVID-19—a ticking time bomb: a case report

Muhammadzai, Hamza Zahid Ullah; Rosal, Nathaniel; Cheema, Muhammad Arslan; Haas, Donald

doi:10.1093/ehjcr/ytac191

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…Our case is unique as the patient had both coronary dissections and LV thrombus, which presented a unique therapeutic challenge. One case report mentioned a large LV thrombus in a patient with COVID-19 pneumonia [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

The Coronavirus Double Threat: A Rare Presentation of Chest Pain in a Young Female

Bashir¹,

Haroon²,

Mahalwar³

et al. 2023

Cureus

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Severe acute respiratory syndrome coronavirus 2 (SARS-COV 2) led to global coronavirus disease 2019 (COVID-19) pandemic. The virus affects the respiratory system predominantly and has resulted in multiorgan complications. Myocarditis, acute coronary syndrome (ACS), cardiogenic shock, and sudden cardiac death were common cardiac manifestations of COVID-19. Spontaneous coronary artery dissection (SCAD) is a rare form of coronary artery disease that is previously reported in patients with COVID-19. SCAD usually occurs in a middle-aged woman with few or without any cardiovascular risk factors. The gold standard for its diagnosis is coronary angiography. The SCAD treatment recommendations depend on the hemodynamic status: conservative therapy in hemodynamically stable SCAD patients and urgent revascularization in hemodynamically unstable SCAD patients. The exact pathophysiology of COVID-19 associated with SCAD is unknown. It is considered a combination of systemic inflammatory response and localized vascular inflammation. The case reported is of COVID-19-associated SCAD in a patient with no history of cardiovascular disease later complicated by the transient ischemic attack (TIA) and left ventricular (LV) thrombus.

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Section: Discussionmentioning

confidence: 99%

The Coronavirus Double Threat: A Rare Presentation of Chest Pain in a Young Female

Bashir¹,

Haroon²,

Mahalwar³

et al. 2023

Cureus

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“…Thrombus formation is more likely to occur in the apical region due to the higher degree of blood stasis in this area [ 8 ]. Risk factors for left ventricular apical thrombus formation include male gender, prior myocardial infarction, apical aneurysm, and ischemic scarring [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

A Case of Left Ventricular Thrombus and Herpetic Esophagitis in an Immunocompetent Patient With COVID-19

Mohamed¹,

Gidda²,

Zavoshi³

et al. 2023

Cureus

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with thrombosis, both venous and arterial, but the mechanism behind this coagulation is not fully understood. Several cases involving coronavirus disease 2019 (COVID-19)-positive patients with left ventricular thrombus (LVT), particularly in those with low ejection fraction, have been reported. This report describes a case of a 57-year-old male patient who presented to the hospital with altered mental status and a positive SARS-CoV-2 polymerase chain reaction (PCR) test. CT of the chest revealed the presence of an LVT, and transthoracic echocardiography showed a reduced ejection fraction and confirmed the presence of the thrombus. The patient also reported epigastric chest pain and several bloody bowel movements. A colonoscopy revealed internal hemorrhoids. An esophagogastroduodenoscopy revealed the presence of multiple esophageal ulcers, and biopsy results confirmed herpes simplex virus (HSV) infection. The patient had no history of organ or bone marrow transplant, long-term immunosuppressive therapy, or HIV infection. He was eventually discharged on apixaban for his LVT and acyclovir for his HSV esophagitis.

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“…The high thrombotic risk determined by COVID-19 is reflected by the case of a 30-year-old woman with HFrEF who developed recurrent thrombosis in the LV and bilateral arterial embolism of lower limbs while on a therapeutic dose of apixaban, one month after infection with SARS-CoV-2 [ 104 ]. The treatment was successful, and the patient was discharged on warfarin, with a good outcome at the two-month follow-up.…”

Section: The Use Of Doacs In Patients With LV Thrombusmentioning

confidence: 99%

Direct Oral Anticoagulants for Stroke and Systemic Embolism Prevention in Patients with Left Ventricular Thrombus

Bădescu

Șorodoc

Lionte

et al. 2023

JPM

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In recent years, direct oral anticoagulants (DOAC) have accumulated evidence of efficacy and safety in various clinical scenarios and are approved for a wide spectrum of indications. Still, they are currently used off-label for left ventricular thrombus owing to a paucity of evidence. For the same reason, there is a lack of guideline indication as well. Our work is based on an exhaustive analysis of the available literature and provides a structured and detailed update on the use of DOACs in patients with left ventricle thrombus. The safety and efficacy of DOACs were analyzed in particular clinical scenarios. As far as we know, this is the first paper that analyzes DOACs in this approach.

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Left ventricular outflow tract thrombus in a patient with COVID-19—a ticking time bomb: a case report

Cited by 4 publications

References 15 publications

The Coronavirus Double Threat: A Rare Presentation of Chest Pain in a Young Female

The Coronavirus Double Threat: A Rare Presentation of Chest Pain in a Young Female

A Case of Left Ventricular Thrombus and Herpetic Esophagitis in an Immunocompetent Patient With COVID-19

Direct Oral Anticoagulants for Stroke and Systemic Embolism Prevention in Patients with Left Ventricular Thrombus

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