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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
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Large thrombus in transit in a COVID-19 patient

Sabine Bleiziffer1, Reinhard Zabel2, Jan F Gummert1

  • 1Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, University Hospital Ruhr-University Bochum, Bad Oeynhausen, Germany.

Interactive Cardiovascular and Thoracic Surgery
|April 4, 2022
PubMed

Insights

This case study details a COVID-19 patient who developed a large intracardiac thrombus despite anticoagulation. Surgical removal was necessary, highlighting the severe thrombotic risks associated with COVID-19.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Hematology

Background:

  • COVID-19 is associated with an increased risk of thromboembolic events.
  • Critically ill COVID-19 patients often receive anticoagulation therapy.
  • Direct thrombin inhibitors like Argatroban are used for anticoagulation.

Observation:

  • A 48-year-old female COVID-19 patient developed a large intracardiac thrombus.
  • The thrombus was diagnosed after extracorporeal membrane oxygenation (ECMO) cannula removal.
  • The thrombus was surgically removed from the atria.

Findings:

  • Histological analysis revealed mixed acute and chronic thrombus portions.
  • The thrombus had unusual finger-like appendices.
  • Despite Argatroban anticoagulation, life-threatening thrombus formation occurred.

Implications:

  • This case underscores the significant risk of intracardiac thrombosis in COVID-19 patients.
  • Therapeutic anticoagulation may not always prevent severe thrombotic complications in COVID-19.
  • Further research into managing thrombotic risks in severe COVID-19 is warranted.

Keywords:
COVID-19Cardiac thrombusThromboembolic event

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