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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
Intracardiac thrombosis in polycythemia vera
Dakshin Gangadharamurthy1, Henry Shih
1Tufts University/Brockton Hospital, Brockton, Massachusetts, USA. dakshin5131@yahoo.com
BMJ Case Reports
|July 11, 2013
Summary
This case study highlights a man diagnosed with polycythemia vera, a condition causing elevated red blood cells. Early diagnosis and treatment involving phlebotomy and medication are crucial for managing this blood disorder.
Area of Science:
- Hematology
- Internal Medicine
- Cardiology
Background:
- Polycythemia vera is a chronic myeloproliferative neoplasm characterized by excessive production of red blood cells.
- Erythrocytosis can lead to various complications, including thrombosis and cardiovascular events.
Observation:
- A male patient in his late 60s presented with itching and headache, exhibiting ruddy complexion and splenomegaly.
- Physical examination revealed normal left ventricular function but an apical left ventricular thrombus measuring 3.0 cm×2.0 cm.
Findings:
- Complete blood count showed significant erythrocytosis (Hemoglobin 18.1 g/dL, Hematocrit 56.6%).
- Low erythropoietin levels and the presence of the JAK2 V617F mutation confirmed the diagnosis of polycythemia vera.
- Transthoracic echocardiogram identified a large left ventricular apical thrombus.
Implications:
- This case underscores the importance of investigating erythrocytosis to rule out underlying conditions like polycythemia vera.
- The presence of a left ventricular thrombus in the context of polycythemia vera highlights the prothrombotic state associated with this disease.
- Prompt diagnosis and multi-modal treatment, including phlebotomy, aspirin, enoxaparin, and hydroxyurea, are essential for managing polycythemia vera and its complications.
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