intracardiac thrombus
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Cureus ◽  
2022 ◽  
Author(s):  
William Lim ◽  
Swann Tin ◽  
May Breitling ◽  
Richard Grodman ◽  
Keith Diaz

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qian Zhang ◽  
Daoyuan Si ◽  
Zhongfan Zhang ◽  
Wenqi Zhang

Abstract Background Loeffler endocarditis is a relatively rare and potentially life-threatening heart disease. This study aimed to identify the characteristic features of Loeffler endocarditis with intracardiac thrombus on a background of hypereosinophilic syndrome (HES). Case presentation We described a 57-year-old woman with Loeffler endocarditis and intracardiac thrombus initially presenting with neurological symptoms, who had an embolic stroke in the setting of HES. After cardiac magnetic resonance (CMR), corticosteroids and warfarin were administered to control eosinophilia and thrombi, respectively. During a 10-month follow-up, the patient performed relatively well, with no adverse events. We also systematically searched PubMed and Embase for cases of Loeffler endocarditis with intracardiac thrombus published until July 2021. A total of 32 studies were eligible and included in our analysis. Further, 36.4% of recruited patients developed thromboembolic complications, and the mortality rate was relatively high (27.3%). CMR was a powerful noninvasive modality in providing diagnostic and follow-up information in these patients. Steroids were administered in 81.8% of patients, achieving a rapid decrease in the eosinophil count. Also, 69.7% of patients were treated with anticoagulant therapy, and the thrombus was completely resolved in 42.4% of patients. Heart failure and patients not treated with anticoagulation were associated with poor outcomes. Conclusions Cardiac involvement in HES, especially Loeffler endocarditis with intracardiac thrombus, carries a pessimistic prognosis and significant mortality. Early steroids and anticoagulation therapy may be beneficial once a working diagnosis is established. Further studies are needed to provide evidence-based evidence for managing this uncommon manifestation of HES.


2021 ◽  
Vol 3 (15) ◽  
pp. 1661-1666
Author(s):  
Mohd Asyiq Raffali ◽  
Syawal Faizal Muhammad ◽  
Patrick Tiau Wei Jyung ◽  
Diyana Farouk ◽  
Awatif Zohdi ◽  
...  

2021 ◽  
Author(s):  
Fatima Zaraket ◽  
Bas Deva ◽  
Jesus Jimenez ◽  
Benjamin Casteigt ◽  
Begoña Benito ◽  
...  

Abstract Background: Pulmonary veins isolation (PVI) is a standard treatment for recurrent atrial fibrillation (AF). Uninterrupted anticoagulation for minimum 3 weeks before the ablation and exclusion of left atrial (LA) thrombus with transesophageal echography (TEE) immediately before or during the procedure minimize peri-procedural risk. We aimed to demonstrate the utility of cardiac tomography (CT) and cardiac magnetic resonance (CMR) to rule out LA thrombus prior to PVI. Methods: Patients undergoing PVI for recurrent AF were retrospectively evaluated. Only patients that started anticoagulation at least 3 weeks prior to the CT/CMR and subsequently uninterrupted until the ablation procedure were selected. An intracardiac echo (ICE) catheter was used in all patients to evaluate LA thrombus. The results of CT/CMR were compared to ICE imaging. Results: We included 272 consecutive patients averaging 54.5 years (71% male; 30% persistent AF). Average CHA2DS2VASC Score was 0.9 and mean LA diameter was 43 mm, 111 patients on Acenocumarol and 161 on direct oral anticoagulants. Anticoagulation was started 227±392 days before the CT/CMR, and 291±416 days before the ablation procedure. CT/CMR diagnosed intracardiac thrombus in 2 cases, both in the LA appendage. A new CT/CMR revealed resolution of thrombus after 6 additional months of uninterrupted anticoagulation. No macroscopic thrombus was observed in any patients with ICE (negative predictive value of 100%; p<0.01).Conclusions: CT and MRI are excellent surrogates to TEE and ICE to rule out intracardiac thrombus in patients adequately anticoagulated prior AF ablation. This is true even for delayed procedures as long as anticoagulation is uninterrupted.


Author(s):  
Umit Arslan ◽  
Ferhat Borulu ◽  
İbrahim Sarac ◽  
Bilgehan Erkut Prof

2021 ◽  
pp. 86-86
Author(s):  
Aziz Ahizoune ◽  
Ahmed Bourazza

Transcortical sensory aphasia is characterized by impaired auditory comprehension, with intact repetition and uent speech. A 44-year-old right-handed patient with a history of hypertension on amlodipine and ischemic heart disease on aspirin was admitted to the neurology department for sudden onset of language impairment that started 2 days ago. The patient had features of transcortical sensory aphasia. Brain MRI showed an infarct in the territory of the left middle cerebral artery involving the tempo-parietal region. An apical thrombus was observed in the left ventricle on transthoracic echocardiography. This language impairment is thought to be caused by a disconnection between sensory language processes and semantic knowledge of objects. The prognosis is generally guarded and depends on the etiology and severity of the presentation


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