Biventricular thrombosis in a structurally normal heart at high altitude

Area of Science:

• Cardiology
• Hematology
• Altitude Medicine

Background:

• Biventricular thrombus is a rare cardiac condition, often associated with underlying pathologies.
• Pulmonary embolism (PE) is a serious complication that can arise from venous or cardiac thrombi.
• High altitude environments present unique physiological challenges, potentially influencing cardiovascular and hematological states.

Observation:

• A young patient with a structurally normal heart presented with symptoms suggestive of biventricular thrombus.
• The patient was residing at high altitude, an environmental factor not typically associated with such cardiac findings.
• Diagnostic workup revealed the presence of extensive thrombi within both ventricles and evidence of pulmonary embolism.

Findings:

• Further investigation identified protein S deficiency, a hereditary thrombophilia, as a significant underlying factor.
• The combination of high altitude exposure and protein S deficiency is hypothesized to have precipitated the unusual thrombus formation.
• This case underscores the potential for rare thrombotic events in individuals with genetic predispositions under specific environmental stressors.

Implications:

• This case emphasizes the importance of considering thrombophilias in young patients with unexplained cardiac thrombi, even in the absence of typical risk factors.
• The findings suggest that high altitude may act as a trigger for thrombotic events in susceptible individuals.
• Understanding the interplay between genetic factors and environmental conditions is crucial for managing and preventing rare thromboembolic complications.