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A case of right atrial thrombus in the Chiari network after blunt cardiac rupture
Takahiro Oishi1, Keisuke Tamagaki2, Shuhei Maruyama1
1Department of Emergency and Critical Care Medicine Kansai Medical University General Medical Center Osaka Japan.
Background:
The Chiari network mostly causes no symptoms but may occasionally be involved in thrombus formation in the right atrium. We present a case of right atrial thrombus discovered in the postoperative course of blunt cardiac rupture.
Case Presentation:
A 19-year-old female injured in a motor vehicle accident was transported to the hospital in a state of shock. Echocardiography revealed pericardial effusion. Cardiopulmonary arrest was imminent, so a clamshell thoracotomy was performed. A laceration at the right atrial junction of the superior vena cava was observed and sutured. Echocardiography on post-injury day 6 showed a floating thrombus in the right atrium. Anticoagulation therapy was started, the thrombus was reduced, and the patient was discharged on day 27 without sequelae. Six months later, echocardiography showed a filamentous structure and the presence of the Chiari network.
Conclusion:
Right intra-atrial thrombi are rare and may warrant a search of the Chiari network in conditions where hypercoagulation is anticipated.
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