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Updated: Jul 8, 2025

Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
[Asymptomatic Ball Thrombus in Right Atrium Under Anticoagulant Therapy:Report of a Case]
Tomoyuki Fujita1, Hiroshi Amano
1Department of Cardiovascular Surgery, Takase Memorial Hospital, Takasaki, Japan.
Insights
An 81-year-old man on warfarin for atrial fibrillation developed a rare right atrial thrombus. Surgical removal was successful, preventing a potentially fatal embolism.
Area of Science:
- Cardiology
- Vascular Surgery
Background:
- Atrial fibrillation (AF) is a common arrhythmia often managed with anticoagulation.
- Oral warfarin is a standard anticoagulant therapy for AF to prevent thromboembolic events.
Observation:
- An 81-year-old male patient on warfarin for AF presented for routine preoperative screening.
- Echocardiography unexpectedly revealed a mobile mass, identified as a right atrial thrombus.
Findings:
- The patient underwent emergency surgical resection of the right atrial thrombus.
- Postoperative imaging confirmed complete removal of the thrombus with no residual mass.
Implications:
- This case highlights the rare occurrence of atrial thrombus formation despite adequate anticoagulation.
- Surgical intervention is a viable and indicated treatment for mobile right atrial thrombi due to embolism risk.
Abstract:
A rare case of isolated right atrial thrombus under anticoagulant therapy for atrial fibrillation is reported herein. The patient was an 81-year-old man undergoing anticoagulant therapy with oral warfarin for atrial fibrillation. During preoperative screening for eye surgery, echocardiography revealed a mobile mass in the right atrium, and emergency hospital admission was indicated. Excision of the right atrial thrombus was performed, and no residual thrombus was detected on postoperative imaging studies. This case was considered a good indication for surgical resection because of potential risk of fatal embolism.
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