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Consumption coagulopathy associated with left atrial thrombosis
M Hanano1, H Takahashi, K Arakawa
1First Department of Internal Medicine, Niigata University School of Medicine, Japan.
Hematologic Pathology
|January 1, 1991
Summary
Consumption coagulopathy linked to left atrial thrombosis in mitral valve disease can be treated. Prompt hemostatic evaluation is crucial for patients with suspected intracardiac thrombosis.
Area of Science:
- Cardiology
- Hematology
- Internal Medicine
Background:
- Mitral valve disease can lead to intracardiac thrombosis, potentially causing coagulopathy.
- Consumption coagulopathy is a rare but serious complication characterized by low fibrinogen and platelet counts.
- Left atrial thrombosis presents a diagnostic challenge, often associated with thromboembolic events.
Observation:
- Three patients presented with consumption coagulopathy secondary to left atrial thrombosis and mitral valve disease.
- Clinical manifestations included hypofibrinogenemia, mild thrombocytopenia, elevated fibrin degradation products (FDP), and thromboembolic events (transient ischemic attacks, retinal vein thrombosis).
- Patients with coagulopathy exhibited lower platelet counts and shorter platelet survival times compared to controls.
Findings:
- Preoperative anticoagulation therapy (heparin or nafamostat mesilate) improved fibrinogen levels and reduced FDP.
- Mitral valve replacement and thrombectomy resolved the coagulopathy.
- Hemostatic evaluation is essential for diagnosing intracardiac thrombosis in patients with unexplained coagulopathy.
Implications:
- Early detection and management of intracardiac thrombosis are vital in patients with mitral valve disease.
- Anticoagulation and surgical intervention can effectively treat consumption coagulopathy associated with left atrial thrombosis.
- This study highlights the importance of hemostatic assessment in patients with suspected intracardiac thrombosis.
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