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Published on: December 19, 2020
Large tricuspid valve thrombus complicating COVID-19 pneumonia
Yasser A Kamal1, Shady E Al-Elwany1, Mostafa M Elsayed1
1Department of Cardiothoracic Surgery, Faculty of Medicine, Minia University, El-Minya, Egypt.
Coronavirus disease 2019 (COVID-19) can rarely cause tricuspid valve thrombus (TVT). Early detection using echocardiography and MRI aids surgical treatment, reducing mortality in these rare COVID-19 complications.
Area of Science:
- Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Coronavirus disease 2019 (COVID-19) is associated with hemostatic disturbances.
- These disturbances can rarely lead to right heart thrombi, including tricuspid valve thrombus (TVT).
Observation:
- A 29-year-old female patient without prior thrombosis history developed TVT and tricuspid regurgitation (TR) during COVID-19 infection.
- Clinical presentation included persistent fever, tachycardia, thrombocytopenia, and elevated d-dimer.
Findings:
- Bedside transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR) confirmed the diagnosis of TVT.
- Surgical intervention involved thrombectomy and tricuspid valve replacement with a tissue valve.
Implications:
- Early detection of TVT in COVID-19 patients is crucial.
- Utilizing a high index of suspicion, bedside TTE, and noninvasive CMR facilitates timely surgical management.
- Prompt treatment can reduce mortality and hospital stay in patients with COVID-19-associated TVT.
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