Document Detail


Acute left atrial thrombosis during anticoagulant therapy in a patient with antithrombin deficiency.
MedLine Citation:
PMID:  19014009     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 47-year-old woman presented to our clinic 1 day after an intervention for a tibial shaft fracture because of sudden onset of chest pain and palpitations. Hospital drug therapy included enoxaparin. The ECG showed atrial fibrillation with a rapid ventricular rate. Transthoracic echocardiography showed a mass in the LA. Transoesophageal echocardiography (TEE) was performed which showed a multilobulated liquid-filled mass (3.6 x 3.7 cm), adherent to the septal, anterior and posterolateral LA most consistent with thrombosis. Tests for hypercoagulable disorders revealed antithrombin deficiency (antithrombin-heparin co-factor level = 30% [normal pooled plasma activity 70%-140%]), suggesting that it played an outstanding role in the LA thrombosis. After initial stabilization, the patient was discharged with warfarin (target INR = 2.5-3.5) together with beta-blockers, statins and metformin. After 1 month of follow-up the patient underwent TEE which showed a dramatic reduction of the left atrial thrombosis. Our patient is doing well and is continuing life-long anticoagulant therapy.
Authors:
Pasquale Santangeli; Alfonso Sestito
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Acta cardiologica     Volume:  63     ISSN:  0001-5385     ISO Abbreviation:  Acta Cardiol     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-11-18     Completed Date:  2009-02-11     Revised Date:  2009-06-11    
Medline Journal Info:
Nlm Unique ID:  0370570     Medline TA:  Acta Cardiol     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  635-7     Citation Subset:  IM    
Affiliation:
Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Rome, Italy. pasquale.santangeli@libero.it
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Anticoagulants / administration & dosage,  adverse effects*
Antithrombin III Deficiency / drug therapy*
Atrial Fibrillation / etiology*
Echocardiography, Transesophageal
Female
Heart Atria / pathology*,  ultrasonography
Humans
Middle Aged
Thromboembolism / chemically induced*,  complications,  etiology,  ultrasonography
Chemical
Reg. No./Substance:
0/Anticoagulants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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