Left ventricular thrombi in a patient with the antiphospholipid syndrome.

Bruce, David A.; Bateman, David; Thomas, R.D.

doi:10.1136/hrt.74.2.202

Cited by 15 publications

(18 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar case reports of intracardiac thrombi have been reported. 4,5 Premature ischaemic heart disease may occur as in our patient; however, the role of anticardiolipin antibodies in this condition is not clear. 6 This documented case of 90% thrombosis of the right subclavian artery and 50% occlusion of both common carotids in the presence of antiphospholipid antibodies fulfils the Sydney criteria for APS diagnosis, which require the presence of at least one of the clinical criteria (Vascular thrombosis and/or pregnancy morbidity) and at least one of the laboratory criteria (Detection of lupus anticoagulant, anticardiolipin or anti-beta-2-glycoprotein 1 antibodies).…”

Section: Discussionmentioning

confidence: 66%

A Case Report of Antiphospholipid Antibody Syndrome- A Diagnosis at a Later Age

Varun¹,

Pragathee²

2017

jemds

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 66%

A Case Report of Antiphospholipid Antibody Syndrome- A Diagnosis at a Later Age

Varun¹,

Pragathee²

2017

jemds

View full text Add to dashboard Cite

show abstract

“…Recently, ventricular thrombosis, right or left, has been documented in association with raised titres of anticardiolipid antibodies of the antiphospholipid group of connective tissue disorders [1,9]. However, to the best of our knowledge, none of those presented with thrombosis of the cardiac veins and/or their tributaries.…”

Section: Discussionmentioning

confidence: 87%

Cardiac vein thrombosis and haemorrhagic myocardial necrosis; report of a case with review of the literature

et al. 2000

View full text Add to dashboard Cite

A 29-year-old woman, addicted to heroin since the age of 15 years, presented with a 4-day history of acute inspiratory chest pain, dyspnoea and vomiting associated with hypoventilation. She died 3 h after admission to the intensive care unit in spite of active resuscitative measures. The main autopsy findings were limited to the heart, which showed widespread cardiac vein thrombosis, and both ventricles and the atria were associated with multiple areas of haemorrhagic myocardial necrosis. We review the literature of this uncommon pathological entity and discuss its possible pathogenesis.

show abstract

“…17 The efficacy of anticoagulant therapy on vegetative lesions is controversial; [11][12][13][14][15][16] some authors have suggested that vascular proliferation, infiltration of fibroblasts, necrosis and calcification are the predominate factors involved in the etiopathogenesis of echogenic masses on the left heart valves in patients with APS, 11,15 and would therefore not be expected to respond to fibrinolytic and anticoagulant therapies, whereas others have reported success in treating these vegetations with anticoagulant therapy. [12][13][14] In addition to the studies of valvular lesions, mural endocardial thrombi have been documented in patients with APS, [1][2][3][4][5][6][7] in some cases, on normal-functioning right and left ventricles. 4,7 There have been few reports of thrombus on the tricuspid valve in patients with APS; Day et al reported a right atrial thrombi associated with PAPS, one of which was adherent to the edge of the anterior leaflet of the tricuspid valve.…”

Section: Discussionmentioning

confidence: 99%

Thrombus on the Tricuspid Valve in a Patient With Primary Antiphospholipid Syndrome After Implantation of an Inferior Vena Cave Filter.

Ebato

Kitai

Kumakura

et al. 2002

Circ J

View full text Add to dashboard Cite

ntiphospholipid syndrome (APS) is a combination of the clinical symptoms of arterial and venous thromboembolism and the presence of autoantibodies such as anticardiolipin 2 GPI antibody, the lupus anticoagulant and the antibodies responsible for the falsepositive serologic test result for syphilis. Primary APS (PAPS) is defined by the presence of these antibodies and thromboembolic phenomena without systemic lupus erythematosus (SLE) and other disease processes. Intracardiac thrombi have been reported, 1-7 but involvement of the tricuspid valve is extremely rare. 5 We report a case of PAPS with a lobulated thrombus on the tricuspid valve, which formed after implantation of a filter in the inferior vena cava (IVC) and resolved with fibrinolytic therapy. Case ReportA 62-year-old woman was admitted with progressive shortness of breath and tachypnea. The patient's medical history included a 15-year history of bronchial asthma, and a pulmonary embolism caused by a deep vein thrombus 5 years previously. At that time, computed tomography (CT) revealed a large thrombus in the main pulmonary artery, which dissolved with intravenous administration of tissue plasminogen activator. Although several perfusion -ventilation mismatch areas remained on the pulmonary perfusion scan after the therapy (segment 6 on the left, segment 8 on the right), she was discharged with no symptoms after the implantation of an IVC filter. Further evaluation during Circulation Journal Vol. 66, April 2002 that admission led to the diagnosis of PAPS with positivity for lupus anticoagulant. The anticardiolipin 2 GPI antibody level was less than 1.2 U/ml. Antinuclear antibodies were negative, and the activities of proteins C and S were normal, consistent with the diagnosis. She had no history of spontaneous abortion and had delivered normally with 3 pregnancies. After discharge, she was treated with warfarin with a target international normalized ratio (INR) of 2.0 at an outpatient clinic.One year later, she was admitted to examine her pulmonary pressure and right heart pressure, which were found to be in the normal range. A repeat pulmonary perfusion scan showed no change. She continued to be positive for lupus anticoagulant at the second admission. Since then, she has been followed at an outpatient clinic and managed with warfarin bronchodilator and warfarin. However, the warfarin therapy was discontinued 10 months prior to her third admission.On the third admission, she had an oxygen saturation of 89%, a respiratory rate of 28 breaths/min, and a 12-lead ECG that showed an inverted T wave in leads V1-3. Chest X-ray suggested dilatation of the right pulmonary artery. Laboratory tests revealed a white blood cell count of 12,500/mm 3 , hematocrit 41.7%, and platelet counts 124,000 /mm 3 . Transthoracic echocardiography revealed a 1.7×1.8 cm, lobulated, isoechoic, highly mobile mass on the septal leaflet of the tricuspid valve (Fig 1). The right atrium and ventricle were dilated and mild tricuspid regurgitation was detected, with an estimated pulmon...

show abstract

Left ventricular thrombi in a patient with the antiphospholipid syndrome.

Abstract: Echocardiographic four chamber view showing thrombi in the left ventricle (LV).

Cited by 15 publications

References 10 publications

A Case Report of Antiphospholipid Antibody Syndrome- A Diagnosis at a Later Age

A Case Report of Antiphospholipid Antibody Syndrome- A Diagnosis at a Later Age

Cardiac vein thrombosis and haemorrhagic myocardial necrosis; report of a case with review of the literature

Thrombus on the Tricuspid Valve in a Patient With Primary Antiphospholipid Syndrome After Implantation of an Inferior Vena Cave Filter.

Contact Info

Product

Resources

About