Open AccessThrombophilia-related complications in the treatment of a left atrial appendage thrombus: A case report
Author(s) -
Vito Maurizio Parato,
Michele Scarano,
Benedetto Labanti
Publication year - 2014
Publication title -
journal of cardiovascular echography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.255
H-Index - 8
eISSN - 2347-193X
pISSN - 2211-4122
DOI - 10.4103/2211-4122.135621
Subject(s) - medicine , thrombus , cardiology , atrial fibrillation , warfarin , thrombophilia , heart failure , dyslipidemia , appendage , activated protein c resistance , factor v leiden , pulmonary embolism , embolism , atrial appendage , thrombosis , venous thrombosis , anatomy , obesity , sinus rhythm
Trans-esophageal echocardiography (TEE) revealed a left atrial appendage (LAA) thrombus in an 84-year-old woman with nonvalvular atrial fibrillation not known before our evaluation. In her medical history, there were hypertension, dyslipidemia and a previous pulmonary embolism. She was taking warfarin at time of our evaluation and presented signs and symptoms of heart failure. Together with heart failure treatment, intravenous anticoagulation with unfractionated heparin was initiated. Treatment was complicated by additional right lower limb embolic event and the LAA thrombus remained unchanged. Testing revealed heterozygosity for both the factor V Leiden and the methylenetetrahydrofolate reductase C677T mutations inducing resistance to activated protein C. The patient refused transcatheter closure of the left atrial appendage.