Open AccessAsymptomatic type B right atrial thrombus in a case with protein S deficiency
Author(s) -
Rajinder Singh Rawat,
Yatin Mehta,
Dheeraj Arora,
Naresh Trehan
Publication year - 2014
Publication title -
annals of cardiac anaesthesia/annals of cardiac anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.42
H-Index - 27
eISSN - 0974-5181
pISSN - 0971-9784
DOI - 10.4103/0971-9784.135877
Subject(s) - medicine , asymptomatic , thrombus , thrombosis , venous thrombosis , cardiopulmonary bypass , thrombolysis , surgery , cardiology , right atrium , myocardial infarction
Thirty seven year old asymptomatic male underwent routine medical examination which revealed an abnormal mass in the right atrium. Family history was not suggestive of any cardiac or malignant disease. Detailed investigation detected deficiency of protein S, which is a vitamin K dependent protein and a cofactor for activated protein C mediated cleavage of factor Va and VIIIa. The deficiency of protein S predisposes to venous thrombosis. Further investigation revealed that it was an organized calcified thrombus in right atrium occupying almost whole of the cavity. Various approaches including surgical excision, thrombolysis and anticoagulation has been used to manage such thrombosis. However therapeutic approach is still a question of debate. Atriotomy and excision of mass was done using cardiopulmonary bypass.