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Acute heart failure and near-syncope associated with giant left atrial ball thrombus occluding left ventricular

Kenan Yalta1, Ahmet Yilmaz, Okan Onur Turgut

  • 1Department of Cardiology, Cumhuriyet University, Sivas 58100, Turkey. hyalta@gmail.com

European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology
|March 23, 2007
PubMed

Insights

A giant left atrial ball thrombus caused acute heart failure and syncope by blocking blood flow. Surgical removal resolved the obstruction and symptoms in this patient.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Pathology

Background:

  • Acute heart failure and syncope can present with various underlying cardiac pathologies.
  • Left atrial masses, though uncommon, pose significant risks due to potential hemodynamic compromise.

Observation:

  • A 70-year-old female presented with acute heart failure and near syncope.
  • Transthoracic and transesophageal echocardiography revealed a large, mobile left atrial mass (4.9 x 3.9 cm).
  • The mass obstructed the left ventricular inflow tract supravalvularly, despite normal mitral valve leaflets.

Findings:

  • The resected left atrial mass was pathologically confirmed as thrombus, consistent with a left atrial ball thrombus (LABT).
  • The obstruction of the left ventricular inflow tract by the giant LABT was the direct cause of the patient's acute diastolic heart failure and syncope.

Implications:

  • Giant LABTs are a critical cause of acute heart failure and syncope, necessitating prompt diagnosis and intervention.
  • Emergent surgical excision is crucial for managing symptomatic LABTs causing significant hemodynamic compromise.
  • This case highlights the importance of echocardiography in identifying intracardiac masses and guiding urgent surgical management.

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