Bi-atrial thrombosis in a patient with SARS-CoV-2 infection: a case report.

European Heart Journal. Case Reports
Ricardo TorresGabriel Patarroyo-Aponte

Abstract

Coronavirus disease 2019 (COVID-19) is a rapidly spreading pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is a multisystemic disease associated with micro- and macrovascular thrombo-embolic complications, including intracardiac thrombosis, which has not been previously reported in the literature. We report a case of a 68-year-old woman with COVID-19 admitted to our intensive care unit with acute respiratory distress, undifferentiated shock, hyperkalaemia, acute kidney injury, and coagulopathy. She received crystalloid infusion, broad-spectrum antibiotics, hydroxychloroquine, insulin-dextrose, calcium gluconate, sodium bicarbonate, and i.v. vasopressors. Continuous renal replacement therapy (CRRT) was started for refractory hyperkalaemia and metabolic acidosis. Transthoracic echocardiogram obtained for concern of pulmonary embolism found bi-atrial thrombosis with normal bi-ventricular dimensions and function. Systemic anticoagulation was provided, but this was stopped soon afterwards due to worsening coagulopathy and bleeding. Despite intensive measures and supportive therapy, the patient developed worsening hypoxia, refractory shock, and multiorgan failure. After discussion of goals of care ...Continue Reading

References

Jan 25, 2020·The New England Journal of Medicine·Na ZhuUNKNOWN China Novel Coronavirus Investigating and Research Team
Feb 20, 2020·Journal of Thrombosis and Haemostasis : JTH·Ning TangZiyong Sun
Feb 29, 2020·The New England Journal of Medicine·Wei-Jie GuanUNKNOWN China Medical Treatment Expert Group for Covid-19
Mar 21, 2020·Lancet·Puja MehtaUNKNOWN HLH Across Speciality Collaboration, UK
Mar 27, 2020·Journal of Thrombosis and Haemostasis : JTH·David Lillicrap
Apr 24, 2020·Lancet·Zsuzsanna VargaHolger Moch
Apr 28, 2020·Journal of Thrombosis and Haemostasis : JTH·Jecko ThachilToshiaki Iba

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BETA
X-ray
PCR

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