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[Left atrial thrombus simulating mitral stenosis].

E Wolfovitz1, S Keidar, E Grenadir

  • 1Dept. of Medicine D, Rambam Medical Center, Haifa.

Harefuah
|March 1, 1990
PubMed
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A dislodged left atrial thrombus, often caused by thrombosis, can mimic mitral stenosis and lead to fatal aortic obstruction. This rare cardiac mass complication highlights the need for vigilant diagnosis and management in patients with atrial fibrillation.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Diagnostic Imaging

Background:

  • Atrial mass is a rare condition with thrombosis as the most common cause, though tumors, vegetations, and fibrosis can also be implicated.
  • Two-dimensional echocardiography is the standard imaging modality for diagnosing suspected cardiac masses.
  • Chronic atrial fibrillation increases the risk of thrombus formation within the atria.

Observation:

  • A 66-year-old woman with chronic atrial fibrillation on anticoagulation presented with symptoms mimicking mitral stenosis.
  • A left atrial thrombus was identified as the cause of her symptoms.
  • The thrombus dislodged, leading to obstruction of the abdominal aorta and superior mesenteric artery.

Findings:

  • The left atrial thrombus, initially presenting as mitral stenosis, embolized distally.

Related Experiment Videos

  • The embolization resulted in critical ischemia of the abdominal aorta and superior mesenteric artery.
  • The patient did not survive surgical intervention for the embolic event.

    • Implications:

    • This case underscores the potential for cardiac thrombi to cause catastrophic systemic embolization.
    • Prompt and accurate diagnosis of atrial masses is crucial to prevent life-threatening complications.
    • Management strategies for atrial masses and associated thromboembolism require careful consideration.