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Coronary sinus thrombosis: Echocardiographic visualization in a patient with known risk factors
Gregory Milligan1, John C Moscona1
1Tulane University School of Medicine, Department of Internal Medicine, 1430 Tulane Ave., SL50, New Orleans, LA 70112.
Insights
Coronary sinus thrombosis, a rare condition, can be detected early using echocardiography in high-risk patients. Prompt anticoagulation management is crucial for favorable outcomes.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Coronary sinus thrombosis (CST) is a rare but serious condition.
- Systolic heart failure and recent cardiac procedures increase risk.
- CST can lead to severe symptoms including syncope and dyspnea.
Observation:
- A case of acute CST is presented in a patient with systolic heart failure post-right-heart catheterization.
- The patient experienced recurrent presyncope, syncope, and shortness of breath.
- Transthoracic echocardiography revealed an echogenic focus indicative of a thrombus, not previously noted.
Findings:
- Coronary sinus thrombosis was diagnosed.
- The patient was successfully managed with oral anticoagulation.
- Early detection via echocardiography is key.
Implications:
- Increased awareness of CST risk factors is essential for timely diagnosis.
- Bedside echocardiography can facilitate early detection of CST.
- Prompt anticoagulation can improve patient outcomes in CST.
Abstract:
Coronary sinus thrombosis is a rare and often overlooked diagnosis that can have fatal consequences. We report a case of acute coronary sinus thrombosis in a patient with systolic heart failure who had undergone recent right-heart catheterization. The patient presented with recurrent presyncope, syncope, and shortness of breath. An echogenic focus consistent with a coronary sinus thrombus was visualized on transthoracic echocardiography that had not been seen previously on recent imaging. The patient was managed on oral anticoagulation. Awareness of patients at risk for coronary sinus thrombosis can lead to early detection via bedside echocardiography and early management.
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