scholarly journals A rare case of mobile ball-like mass in right atrium associated with dilated cardiomyopathy

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Jing Dong ◽  
◽  
Yiqun Gao ◽  
Shunji Liang ◽  
Guorong Deng ◽  
...  
Keyword(s):  
Anticoagulant Therapy ◽  
Right Atrium ◽  
Early Recognition ◽  
Therapeutic Option ◽  
Venous Pressure ◽  
Rare Condition ◽  
Good Clinical Condition ◽  
Mobile Mass ◽  
2D Echocardiogram ◽  
The Right

Mobile thrombus in the Right Atrium (RA) is a rare condition. Here, we described a case of a 59-year-old male who presented in emergency room with complaints of progressively worsening dyspnea for 7 years. He was normotensive, had elevated jugular venous pressure and clear lungs. ECG revealed ventricular tachycardia. After successfully electrical defibrillation, an urgent 2D echocardiogram was obtained and revealed the enlargement of all heart chambers and a ball-like, mobile mass in the right atrium. An emergent CT scan revealed no sign of pulmonary embolism. Based on morphological features on echocardiogram, we highly suspected it as RA thrombus. The patient was treated with anticoagulant therapy comprising of low molecular heparin and warfarin since he rejected surgical treatment. Repeat echocardiogram was performed 7 days after anticoagulant therapy and showed disappearance of the RA mass. He was subsequently maintained on warfarin (INR=2.4- 3.0) and other medications for heart failure. The patient was followed up as outpatient and kept in good clinical condition. We concluded that early recognition of this rare situation and prompt management can help in preventing life-threatening complications, and anticoagulant therapy was a therapeutic option for RA thrombus.

Central venous pressure monitoring in critical care settings

2021 ◽  
Vol 30 (4) ◽  
pp. 230-236
Author(s):  
Barry Hill ◽  
Catherine Smith
Keyword(s):  
Critical Care ◽  
Central Venous Pressure ◽  
Right Atrium ◽  
Venous Pressure ◽  
Vena Cava ◽  
Alternative Methods ◽  
Haemodynamic Monitoring ◽  
Haemodynamic Instability ◽  
Central Venous ◽  
The Right

Patients who present with acute cardiovascular compromise require haemodynamic monitoring in a critical care unit. Central venous pressure (CVP) is the most frequently used measure to guide fluid resuscitation in critically ill patients. It is most often done via a central venous catheter (CVC) positioned in the right atrium or superior or inferior vena cava as close to the right atrium as possible. The CVC is inserted via the internal jugular vein, subclavian vein or via the femoral vein, depending on the patient and their condition. Complications of CVC placement can be serious, so its risks and benefits need to be considered. Alternative methods to CVC use include transpulmonary thermodilution and transoesophageal Doppler ultrasound. Despite its widespread use, CVP has been challenged in many studies, which have reported it to be a poor predictor of haemodynamic responsiveness. However, it is argued that CVP monitoring provides important physiologic information for the evaluation of haemodynamic instability. Nurses have central roles during catheter insertion and in CVP monitoring, as well as in managing these patients and assessing risks.

scholarly journals P189 Duplication of the tricuspid valve (DOTV): case report of a rare congenital anomaly

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Moscatelli ◽  
G Trocchio ◽  
N Stagnaro ◽  
A Siboldi ◽  
M Derchi ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Atrial Flutter ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Right Atrium ◽  
Rare Condition ◽  
Systolic Pulmonary Artery Pressure ◽  
Severe Tricuspid Regurgitation ◽  
One Year ◽  
The Right

Abstract Introduction Tricuspid valve duplication is an extremely rare condition and in most of the cases it is associated with other congenital cardiac malformations. Because of its rarity, the clinical presentation and the management are not defined yet. Clinical Case We report the case of an 18 y/o caucasian male, who was admitted to our Hospital in February 2018 for rapid atrial flutter not responsive to medical therapy (propanolol and digossin). He had a pre-natal diagnose of ventricular septum defect (VSD) and tricuspid straddling. At 1 year of age he underwent pulmonary artery bandage and one year later VSD closure was performed. Blood test showed sub-clinic hypothyroidism, probably related to previous amiodaron therapy. A transthoracic echocardiogram was obtained. The right atrium (RA) was severely dilated and the atrial septum dislocated towards left ventricle (LV); two right atrioventricular valves (tricuspid valves) were detected: the ‘true’ tricuspid opening was inside the right ventricle, and an ‘accessory‘ opening was located inside the LV and severely regurgitant into the RA; the mitral valve was morphologically and functionally normal; both ventricles were dilated with preserved systolic function; systolic pulmonary artery pressure was not detectable. A Cardiac Magnetic Resonance clearly delineated the anomaly. Atrial flutter radio frequency transcatheter ablation was succesfully performed before corrective surgery. The regurgitant accessory tricuspid orifice was closed with an heterologous pericardial patch and a right reduction atrioplasty was also done. The post-operative course was uneventful and only a mild paraseptal tricuspid jet with LV to RA shunt was present at post op echocardiography. After one year follow-up the patient remained asymptomatic, without arrhythmia recurrence. Conclusion DOTV is an extremely rare condition that could be responsible of severe tricuspid regurgitation. At the moment, there are not sufficient data to establish the correct timing for surgical intervention. In our case, the presence of severe tricuspid regurgitation, right atrium dilatation, biventricular overload and atrial flutter guided the clinical management and suggested surgical correction. Abstract P189 Figure.

Orthostatic hypotension and right heart failure as the initial manifestation of intravenous leiomyomatosis

2015 ◽  
Vol 26 (3) ◽  
pp. 586-588 ◽  
Author(s):  
Ya-Qin Li ◽  
Xiao-Ping Yin ◽  
Zhan-Wen Xu
Keyword(s):  
Right Atrium ◽  
Right Heart Failure ◽  
Intravenous Leiomyomatosis ◽  
Right Heart ◽  
Caval Vein ◽  
Initial Manifestation ◽  
Inferior Caval Vein ◽  
Mobile Mass ◽  
History Of ◽  
The Right

AbstractA 36-year-old woman, who had a history of myomectomy, presented with lightheadedness after changing position from sitting to standing and effort-related shortness of breath. Echocardiography demonstrated a hyperechoic elongated mobile mass extending from the inferior caval vein to the right atrium. The mass was surgically removed, and histological examination established the diagnosis of intravenous leiomyomatosis. This case caught the attention of our cardiology group to consider the diagnosis when an inferior caval vein or right atrium mass is found in a patient with a history of uterine leiomyomatosis.

scholarly journals Novel Point-of-Care Ultrasound (POCUS) Technique to Modernize the JVP Exam and Rule out Elevated Right Atrial Pressures

2021 ◽  
Author(s):  
Larry Istrail ◽  
Maria Stepanova
Keyword(s):  
Right Atrium ◽  
Point Of Care ◽  
Venous Pressure ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Right Atrial ◽  
Point Of Care Ultrasound ◽  
Status Assessment ◽  
Left Ventricular Outflow ◽  
The Right

Accurate assessment of the jugular venous pressure (JVP) and right atrial pressure (RAP) has relied on the same bedside examination method since 1930. While this technique provides a rough estimate of right-sided pressures, it is limited by poor sensitivity and overall diagnostic inaccuracy. The internal jugular vein (IJV) is difficult to visualize in many patients and relies on an incorrect assumption that the right atrium lies 5 centimeters below the sternum. Point-of-care ultrasound (POCUS) offers an alternative method for more precisely estimating JVP and RAP. We propose a novel method of measuring the right atrial depth (RAD) using a sonographic measurement of the depth of the posterior left ventricular outflow tract as a surrogate landmark to the center of the right atrium when viewed in the parasternal long axis view. This is combined with determination if JVD was present at the supraclavicular point. Sensitivity, specificity, PPV, NPV of JVD at the supraclavicular point was 70%, 76%, 59%, 91% respectively. These values were confounded by the lack of standardization of zero reference landmarks (ZRLs) used during the right heart catheterizations. When the RAD estimate was adjusted to account for measurement error the sensitivity of JVD at supraclavicular point for elevated RAP improved to 90% with negative predictive value of 96%. This may offer a rapid and reliable method for ruling out elevated RAP and increase objectivity in our volume status assessment.

scholarly journals Atrial thrombus as a complication of SLE and APS in an 8-year-old child

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Hai-bo Yan ◽  
Yu-mei Li
Keyword(s):  
Nephrotic Syndrome ◽  
Anticoagulant Therapy ◽  
Right Atrium ◽  
Rare Complication ◽  
Renal Involvement ◽  
Clinical Manifestations ◽  
Disease Diagnosis ◽  
Urinary Protein ◽  
Multiple Systems ◽  
The Right

Abstract Background Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple systems with various clinical manifestations. Renal involvement is common, but intracardiac thrombus is rarely reported as a complication of antiphospholipid syndrome (APS, also known as anticardiolipin syndrome). Anticoagulant therapy is the first-line treatment, and surgery is performed in severe cases. We report a case to improve clinicians’ understanding of disease diagnosis. Case presentation An 8-year-old girl was admitted to our hospital because of left costal pain, hematuria and fever. She had obvious edema occult blood 3+, urinary protein 3.2 g/24 h, albumin 17.6 g/L, and total cholesterol 7.21 mmol/L, consistent with a diagnosis of nephrotic syndrome. We continued to track the etiology of nephrotic syndrome and performed a renal biopsy, showing dsDNA 1:10 positivity, low C3, low platelets and hemoglobin, anticardiolipin IgM 12 U/ml, anti-β2-glycoprotein I (β2GPI) 223 U/ml; renal pathology suggested lupus nephritis (LN), and the patient was ultimately diagnosed with SLE, secondary APS and LN. The patient was treated with hormones and immunosuppressants. Sixteen weeks later, her urinary protein was 1+, and the quantity of urine protein was less than 0.5 g/d. Echocardiography showed that the mass in the right atrium was thrombotic. Heparin anticoagulant therapy was effective. Conclusion SLE can involve multiple systems and various complications. Thrombus in the right atrium is a rare complication of APS. Early diagnosis and treatment are key to improving the prognosis of children.

Accuracy of Central Venous Pressure Measuremet From the Abdominal Inferior Vena Cava

PEDIATRICS ◽  
1992 ◽  
Vol 89 (3) ◽  
pp. 506-508
Author(s):  
THOMAS R. LLOYD ◽  
RICHARD L. DONNERSTEIN ◽  
ROBERT A. BERG
Keyword(s):  
Inferior Vena Cava ◽  
Central Venous Pressure ◽  
Right Atrium ◽  
Inferior Vena ◽  
Venous Pressure ◽  
Vena Cava ◽  
Pressure Measurements ◽  
Central Venous ◽  
The Mean ◽  
The Right

Central venous pressure measurements in the abdominal inferior vena cava were compared with measurements in the right atrium in 10 infants and 10 children during cardiac catheterization. At end expiration, the mean pressures at these two sites were within 1 mm Hg of each other in all 20 patients, with a mean difference of 0.0 ± 0.36 mm Hg. The abdominal inferior vena cava is a safe and convenient site for measurement of central venous pressure, and our study confirms that such measurements are accurate.

A Rare Case of a Pedicled Mobile Thrombus in Right Atrium

2016 ◽  
Vol 19 (6) ◽  
pp. 269 ◽  
Author(s):  
Xiaodong Li ◽  
Liping Chen ◽  
Xiumei Duan ◽  
Xiaocong Wang
Keyword(s):  
Right Atrium ◽  
Histopathological Examination ◽  
Rare Condition ◽  
Computed Tomographic Angiography ◽  
Right Atrial ◽  
Atrial Thrombus ◽  
Computed Tomographic ◽  
Right Atrial Thrombus ◽  
The Right ◽  
Tomographic Angiography

Pedicled mobile thrombus in the right atrium is an extremely rare condition. Here, we described a case of a 42-year-old male hospitalized with complaints of chest pain and hemoptysis. Computed tomographic angiography of the pulmonary artery showed signs of embolism, and thoracic echocardiography indicated a pedicled mobile cloudy echo in the right atrium, which was initially suspected to be a myxoma. However, it was confirmed to be a thrombus by histopathological examination. Postoperatively, the patient was treated with anticoagulant therapy comprising of low molecular heparin and warfarin, and the patient recovered well. Thoracic echocardiography performed 3 months after surgery ruled out any recurrence of right atrial thrombus.

Right atrium and renal sodium excretion

1975 ◽  
Vol 228 (1) ◽  
pp. 184-190 ◽  
Author(s):  
SO Stitzer ◽  
RL Malvin
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Right Atrium ◽  
Venous Pressure ◽  
Right Atrial ◽  
Binary Response ◽  
Balloon Inflation ◽  
Water Excretion ◽  
Significant Difference ◽  
The Right

Inflation of a balloon in the right atrium of 13 dogs resulted in salt and water retention not attributable to changes in GFR, RPF, filtration fraction, mean arterial pressure, left atrial pressure, or renal venous pressure. The response to right atrial balloon inflation was compared with the renal effects of constriction of the abdominal aorta above the renal arteries and constriction of the ascending aorta. Neither procedure evoked the same response as balloon inflation. Results suggest that the decrease in mean arterial pressure which accompanies balloon inflation accounts for only part of the decreased salt and water excretion. There was no significant difference between the responses of denervated and intact kidneys to right atrial balloon inflation. A binary response to stretching of the right atrium is suggested, both components apparently involving hormonal mediation.

TUBERCULOUS BRAINSTEM ABSCESS

Neurosurgery ◽  
2009 ◽  
Vol 65 (6) ◽  
pp. E1206-E1207 ◽  
Author(s):  
Yu-Gang Jiang ◽  
Jing Chen ◽  
Yong Peng
Keyword(s):  
Early Recognition ◽  
Rare Condition ◽  
Poor Response ◽  
Antituberculous Therapy ◽  
Adequate Treatment ◽  
Mortality And Morbidity ◽  
Vulnerable Patients ◽  
Tuberculous Abscess ◽  
The Right ◽  
Mass Lesions

Abstract OBJECTIVE Tuberculous brainstem abscess is a clinically rare condition with potentially high mortality and morbidity. We present this report to draw attention to the importance of early recognition and adequate treatment of tuberculous brainstem abscess. CLINICAL PRESENTATION A 24-year-old man complained of longstanding fever, headache, and weakness followed by development of progressive slurred speech and hemiparesis of the right extremities. Magnetic resonance imaging revealed a large thick-walled cystic lesion lying within the brainstem. INTERVENTION The patient demonstrated a remarkable clinical recovery after microsurgery combined with a course of antituberculous therapy. Microbiological and histological findings confirmed the diagnosis of a tuberculous abscess. CONCLUSION Despite its rarity, the tuberculous brainstem abscess must be considered in the differential diagnosis of cystic brainstem mass lesions in vulnerable patients. When confronted with progressing neurological deterioration and poor response to antituberculous therapy, stereotactic or microsurgical management should be considered. Microsurgical excision combined with a complete course of antituberculous therapy in our patient led to a good outcome.

Case Report: Total Nephrectomy for Renal Hydatidosis

2021 ◽  
Author(s):  
Gustavo Hernández-Córdova ◽  
Virgilio E. Failoc-Rojas ◽  
Rigel Tarco ◽  
Sebastian Iglesias-Osores ◽  
Franco Romaní
Keyword(s):  
Back Pain ◽  
Case Report ◽  
Early Detection ◽  
Pediatric Patients ◽  
Therapeutic Option ◽  
Rare Condition ◽  
Gross Hematuria ◽  
Lower Back ◽  
The Right ◽  
Total Nephrectomy

Cystic echinococcosis, known as hydatidosis, is a parasitic zoonosis caused by the larvae of Echinococcus granulosus. Renal hydatidosis is a very rare condition, representing 1% to 2% of cases. We present an 18-year-old patient who, after suffering a trauma, experienced severe lower back pain and persistent gross hematuria disproportionate to the trauma. Ultrasonography and tomography revealed cystic images compatible with right renal hydatidosis and hemoperitoneum. In addition, rapid clinical deterioration was observed with decreased hematocrit, leading to lumpectomy with abundant cysts inside and outside the right kidney, without viable parenchyma. Therefore, a total nephrectomy was performed. The patient was discharged with albendazole treatment. Pathological anatomic analysis confirmed the diagnosis of hydatidosis. Surgery remains the best therapeutic option. The use of ultrasonography improves the early detection of zoonosis, especially in pediatric patients, and favors the use of more conservative therapeutic techniques.

Sign in / Sign up

Export Citation Format

Share Document