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Left ventricular thrombosis due to acquired protein C deficiency diagnosed by two-dimensional echocardiography
S Ozkutlu1, N Ozbarlas, M Saraçlar
1Department of Cardiology, Hacettepe University, Ankara, Turkey.
Insights
This study reports the first case of left ventricular thrombus caused by acquired protein C deficiency. Prompt treatment led to thrombus resolution and normalization of protein C levels.
Area of Science:
- Cardiology
- Hematology
- Hepatology
Background:
- Left ventricular thrombus (LVT) is a serious condition often associated with impaired cardiac function.
- Acquired deficiencies in coagulation factors, such as protein C, can predispose individuals to thrombotic events.
- The interplay between liver dysfunction, sepsis, heart failure, and coagulation abnormalities requires further investigation.
Observation:
- A patient presented with a left ventricular thrombus diagnosed via two-dimensional echocardiography.
- The thrombus was attributed to a transient, acquired protein C deficiency.
- This deficiency stemmed from impaired liver function secondary to hepatitis, sepsis, and heart failure.
Findings:
- Successful treatment resulted in the complete resolution of the left ventricular thrombus within four days.
- Protein C levels normalized eighteen weeks after the initial presentation.
- This case represents the first documented instance of a left-sided cardiac thrombus linked to protein C deficiency.
Implications:
- Echocardiographic evaluation and monitoring are crucial for suspected intracardiac thrombus cases.
- Measuring protein C levels should be considered in patients with unexplained cardiac thrombi, especially those with liver dysfunction or sepsis.
- This case highlights the importance of assessing coagulation status in complex critical illnesses involving cardiac and hepatic dysfunction.
Abstract:
We present a patient with left ventricular thrombus diagnosed by two-dimensional echocardiography. Thrombosis was due to acquired transient protein C deficiency which was caused by impaired liver function due to hepatitis, sepsis and heart failure. With proper treatment the thrombus disappeared on the fourth day. Eighteen weeks later the protein C level returned to normal. We recommend echocardiographic evaluation and follow-up of suspected cases for intracardiac thrombus. The measurement of protein C level in such cases is proposed. This is the first case with left-sided cardiac thrombus associated with protein C deficiency in the medical literature.