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Multiple-shower thromboembolism in an artificial mitral valve patient
Ori Argov1, Moshe Weintraub, Gideon Charach
1Department of Internal Medicine C, Tel Aviv Sourasky Medical Center, Weiztman street 6, Tel Aviv 64239, Israel. argovori@gmail.com
BMC Research Notes
|January 5, 2013
Summary
Failure to provide anticoagulation for a patient with an artificial heart valve led to catastrophic left atrial thrombosis and fatal emboli. This highlights the critical need for anticoagulation in patients with mechanical valves to prevent severe complications.
Area of Science:
- Cardiology
- Vascular Medicine
- Hematology
Background:
- Late acute left atrial thrombosis is a rare but life-threatening complication.
- Predisposing factors include primary coagulopathies like Protein C, Protein S, antithrombin 3 deficiency, antiphospholipid syndrome, or hyperhomocysteinemia.
Observation:
- A 47-year-old male with an artificial mitral valve did not receive anticoagulation during a prior hospitalization.
- He presented with lower limb weakness, diagnosed with extensive emboli disease and complete distal aorta occlusion.
- Multiple organ infarcts (spleen, kidneys, muscles) and multi-organ failure were noted.
Findings:
- Lack of anticoagulation in a patient with a mechanical heart valve resulted in severe left atrial thrombosis.
- Shower thrombemboli led to disseminated vascular occlusion from the left atrium to the abdominal aorta.
- Complete occlusion of the distal aorta, spleen, kidney, and muscle infarcts were observed.
Implications:
- This case underscores the critical importance of adhering to anticoagulation protocols for patients with mechanical heart valves.
- Neglecting anticoagulation can precipitate immediate, catastrophic embolic events and multi-organ failure.
- Prompt anticoagulation is essential to prevent severe morbidity and mortality in this patient population.
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