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[Cauliflower-like giant left atrial thrombus successfully treated by anticoagulants without systemic complication: a
Chinami Ogata1, Satoshi Nakatani, Yoshio Yasumura
1Division of Cardiovascular Medicine, National Cardiovascular Center, Fujishiro-dai 5-7-1, Suita, Osaka 565-8565.
Insights
A giant left atrial mass, initially suspected to be serious, was successfully treated with anticoagulant therapy in a 64-year-old woman. This case highlights a non-surgical approach for managing large cardiac thrombus.
Area of Science:
- Cardiology
- Cardiovascular Medicine
- Internal Medicine
Background:
- Giant left atrial masses can present diagnostic challenges, particularly in patients with underlying conditions like congestive heart failure.
- Hypertension is a common comorbidity that may influence cardiovascular events.
Observation:
- A 64-year-old woman with hypertension and congestive heart failure presented with a large, mobile, cauliflower-like mass in the left atrium.
- Transesophageal echocardiography confirmed the mass (3 x 2 cm) attached to the left atrial wall, with no signs of systemic embolism.
Findings:
- Anticoagulant therapy was initiated, leading to a gradual reduction and near-complete resolution of the mass within 10 days.
- The patient remained asymptomatic throughout the treatment period, supporting the diagnosis of a cardiac thrombus.
Implications:
- This case demonstrates the potential efficacy of anticoagulation in managing large left atrial thrombi, challenging the necessity of surgical intervention in all instances.
- Successful conservative management of cardiac thrombus can prevent embolic complications and improve patient outcomes.
Abstract:
A 64-year-old woman with hypertension presented with a left atrial giant mass during the treatment of congestive heart failure. She was admitted to our hospital for intensive treatment. Transesophageal echocardiography demonstrated a cauliflower-like, large (3 x 2 cm), mobile echogenic mass attached to the left atrial wall. There were no signs of systemic embolism. Anticoagulant therapy was started. Repeated echocardiography showed the mass was reduced gradually and had diminished on the 10th day. She remained asymptomatic during the anticoagulant therapy. The diagnosis was thrombus based on the response to treatment. Surgical removal should be considered for such a large thrombus, but the present case of giant thrombus was successfully treated by anticoagulants without systemic complication.