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Post COVID-19 Large Atrial Thrombus Found Incidentally

Fouad Khalil1, Muhammad Hamza Saad Shaukat2, Swaminathan Perinkulam Sathyanarayanan1

  • 1Department of Internal Medicine, University of South Dakota, Sioux Falls, South Dakota.

South Dakota Medicine : the Journal of the South Dakota State Medical Association
|June 15, 2022
PubMed

Insights

Even mild COVID-19 can cause serious blood clots, including right atrial thrombi, even in vaccinated individuals. Early diagnosis and anticoagulation are key for managing these cardiovascular complications.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Hematology

Background:

  • Coronavirus disease 2019 (COVID-19) is a global health crisis associated with significant morbidity and mortality.
  • A notable complication of COVID-19 is a hypercoagulable state, increasing the risk of cardiac thrombi and venous thromboembolism (VTE).
  • Existing research primarily links severe COVID-19 to thromboembolic events, with less focus on milder cases or vaccinated individuals.

Observation:

  • A case report details an 85-year-old male diagnosed with a large right atrial (RA) thrombus in transit.
  • The diagnosis was incidental, occurring two weeks after a mild COVID-19 infection in a fully vaccinated patient.
  • Computed tomography with angiography revealed acute pulmonary thromboembolic disease with a substantial clot burden and signs of right heart strain.

Findings:

  • Right atrial (RA) thrombi and VTE can manifest even after mild COVID-19 infection.
  • These thromboembolic events are possible in patients who have completed their COVID-19 vaccination series.
  • The patient, despite the large clot burden, remained hemodynamically stable and was successfully treated with anticoagulation.

Implications:

  • This case highlights that mild COVID-19 and vaccination do not preclude the risk of significant thromboembolic events.
  • Echocardiography is identified as a valuable diagnostic tool for evaluating RA thrombi in this patient demographic.
  • Clinicians should maintain a high index of suspicion for VTE and cardiac thrombi in patients recovering from COVID-19, regardless of disease severity or vaccination status.
Abstract

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