Right Heart Thrombus in an Adult COVID-19 Patient: A Case Report

The Journal of Critical Care Medicine
Enrico MerloGabriele Martelli

Abstract

Right heart thrombus (RiHTh) can be considered a rare and severe condition associated with thromboembolic phenomena. A case is described of a COVID-19 patient presenting with an isolated thrombus in the right ventricle. An 80-years-old Caucasian male was admitted in an intensive care unit (ICU) for COVID-19 related acute respiratory distress syndrome. The patient showed signs of hemodynamic instability, elevated cardiac troponin I and altered coagulation. On further assessment, a thrombotic mass near the apex of the right ventricle was detected. Moreover, the apex and the anteroseptal wall of the right ventricle appeared akinetic. Following the administration of a therapeutic dose of unfractionated heparin over a forty-eight hour period, re-evaluation of the right chambers showed that the thrombotic mass had resolved entirely. COVID-19 patients could constitute a population at risk of RiHTh. Routine use of echocardiography and a multidisciplinary approach can improve the management of this condition.

References

Apr 11, 2014·The New England Journal of Medicine·Guy MeyerUNKNOWN PEITHO Investigators
Jan 23, 2016·The European Respiratory Journal·Marcin KoćUNKNOWN RiHTER Investigators
Dec 25, 2016·The American Journal of Medicine·Deisy BarriosUNKNOWN Registro Informatizado de la Enfermedad TromboEmbólica Investigators
May 10, 2017·The American Journal of Medicine·Deisy BarriosUNKNOWN Registro Informatizado de la Enfermedad TromboEmbólica Investigators
Feb 20, 2020·Journal of Thrombosis and Haemostasis : JTH·Ning TangZiyong Sun
Mar 13, 2020·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Bo LiYunhe Zhao
Apr 28, 2020·European Heart Journal Cardiovascular Imaging·Samir SulemaneShelley Rahman-Haley
May 18, 2020·Intensive Care Medicine·Bérangère S JolyAgnès Veyradier

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Citations

Mar 15, 2021·Hipertensión y riesgo vascular·A Cuevas VilaplanaJ Vizuete Del Río
Jun 3, 2021·Annals of Medicine and Surgery·Ghizlane El AidouniBrahim Housni

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