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Left atrial appendage thrombus in a patient in sinus rhythm with endocarditis and a severe aortic valve insufficiency

M Shanks1, B Cujec, J B Choy

  • 1University of Alberta, Edmonton, Canada.

The Canadian Journal of Cardiology
|October 9, 2008
PubMed

Insights

A left atrial thrombus, usually linked to atrial fibrillation, was found in a patient with sinus rhythm. This rare case also involved aortic valve endocarditis, a previously undescribed association.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Neurology

Background:

  • Left atrial thrombus formation is typically associated with conditions like atrial fibrillation and rheumatic mitral stenosis.
  • Detecting left atrial thrombus in patients with normal sinus rhythm is uncommon.

Observation:

  • A 66-year-old woman presented with a stroke.
  • Imaging revealed two potential embolic sources: a vegetation on the native aortic valve causing severe aortic insufficiency, and a left atrial appendage thrombus.
  • The patient was in sinus rhythm throughout the evaluation.

Findings:

  • The case report details the first known instance of a left atrial thrombus occurring in a patient with sinus rhythm.
  • This thrombus was found in conjunction with aortic valve endocarditis and severe aortic insufficiency.

Implications:

  • This case expands the understanding of left atrial thrombus etiology beyond typical associations.
  • Highlights the importance of thorough cardiac evaluation in stroke patients, even those in sinus rhythm.
  • Suggests a potential link between aortic valve endocarditis and left atrial thrombus formation in the absence of arrhythmias.

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