Intracardiac thrombus and Murphy's law: Reflections on a clinical dilemma

Intracardiac thrombus and Murphy's law: Reflections on a clinical dilemma

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We discuss the case of a 49-year-old patient with left ventricular systolic dysfunction and a large, mobile and protruding apical thrombus. In spite of anticoagulation treatment, extensive and clearly defined systemic embolization occurred.We discuss the current evidence on the treatment of intracar...

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Main Authors: Patrícia Rodrigues, Maria João Sousa, Luísa Caiado, Sofia Cabral, Ana Meireles, Mário Santos, Paulo Palma, Severo Torres
Format: Article
Language:English
Published: Elsevier 2016-04-01
Series:Revista Portuguesa de Cardiologia
Online Access:http://www.sciencedirect.com/science/article/pii/S0870255116000676
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spelling doaj-8e13308d18304aa39f655324e3844b6d2020-11-25T02:06:56ZengElsevierRevista Portuguesa de Cardiologia0870-25512016-04-01354233.e1233.e3Intracardiac thrombus and Murphy's law: Reflections on a clinical dilemmaPatrícia Rodrigues0Maria João Sousa1Luísa Caiado2Sofia Cabral3Ana Meireles4Mário Santos5Paulo Palma6Severo Torres7Corresponding author.; Cardiology Department, Centro Hospitalar do Porto, Porto, PortugalCardiology Department, Centro Hospitalar do Porto, Porto, PortugalCardiology Department, Centro Hospitalar do Porto, Porto, PortugalCardiology Department, Centro Hospitalar do Porto, Porto, PortugalCardiology Department, Centro Hospitalar do Porto, Porto, PortugalCardiology Department, Centro Hospitalar do Porto, Porto, PortugalCardiology Department, Centro Hospitalar do Porto, Porto, PortugalCardiology Department, Centro Hospitalar do Porto, Porto, PortugalWe discuss the case of a 49-year-old patient with left ventricular systolic dysfunction and a large, mobile and protruding apical thrombus. In spite of anticoagulation treatment, extensive and clearly defined systemic embolization occurred.We discuss the current evidence on the treatment of intracardiac thrombus with high risk of systemic embolization and propose a tailored approach to avoid potential catastrophic consequences. Resumo: Apresentamos o caso de um doente de 49 anos com disfunção sistólica ventricular esquerda e um trombo apical de grandes dimensões, móvel e com protrusão para a cavidade ventricular. Apesar do tratamento anticoagulante, ocorreram vários fenómenos de embolização sistémica, extensos e muito ilustrativos.Discutimos a evidência atual sobre o tratamento de trombos intracardíacos com alto risco de embolização sistémica e propomos uma reflexão sobre uma abordagem personalizada para evitar potenciais consequências catastróficas. Keywords: Left ventricular thrombus, Embolization, Anticoagulation, Thrombectomy, Palavras-chave: Trombo do ventrículo esquerdo, Embolização, Anticoagulação, Trombectomiahttp://www.sciencedirect.com/science/article/pii/S0870255116000676
collection DOAJ
language English
format Article
sources DOAJ
author Patrícia Rodrigues
Maria João Sousa
Luísa Caiado
Sofia Cabral
Ana Meireles
Mário Santos
Paulo Palma
Severo Torres
spellingShingle Patrícia Rodrigues
Maria João Sousa
Luísa Caiado
Sofia Cabral
Ana Meireles
Mário Santos
Paulo Palma
Severo Torres
Intracardiac thrombus and Murphy's law: Reflections on a clinical dilemma
Revista Portuguesa de Cardiologia
author_facet Patrícia Rodrigues
Maria João Sousa
Luísa Caiado
Sofia Cabral
Ana Meireles
Mário Santos
Paulo Palma
Severo Torres
author_sort Patrícia Rodrigues
title Intracardiac thrombus and Murphy's law: Reflections on a clinical dilemma
title_short Intracardiac thrombus and Murphy's law: Reflections on a clinical dilemma
title_full Intracardiac thrombus and Murphy's law: Reflections on a clinical dilemma
title_fullStr Intracardiac thrombus and Murphy's law: Reflections on a clinical dilemma
title_full_unstemmed Intracardiac thrombus and Murphy's law: Reflections on a clinical dilemma
title_sort intracardiac thrombus and murphy's law: reflections on a clinical dilemma
publisher Elsevier
series Revista Portuguesa de Cardiologia
issn 0870-2551
publishDate 2016-04-01
description We discuss the case of a 49-year-old patient with left ventricular systolic dysfunction and a large, mobile and protruding apical thrombus. In spite of anticoagulation treatment, extensive and clearly defined systemic embolization occurred.We discuss the current evidence on the treatment of intracardiac thrombus with high risk of systemic embolization and propose a tailored approach to avoid potential catastrophic consequences. Resumo: Apresentamos o caso de um doente de 49 anos com disfunção sistólica ventricular esquerda e um trombo apical de grandes dimensões, móvel e com protrusão para a cavidade ventricular. Apesar do tratamento anticoagulante, ocorreram vários fenómenos de embolização sistémica, extensos e muito ilustrativos.Discutimos a evidência atual sobre o tratamento de trombos intracardíacos com alto risco de embolização sistémica e propomos uma reflexão sobre uma abordagem personalizada para evitar potenciais consequências catastróficas. Keywords: Left ventricular thrombus, Embolization, Anticoagulation, Thrombectomy, Palavras-chave: Trombo do ventrículo esquerdo, Embolização, Anticoagulação, Trombectomia
url http://www.sciencedirect.com/science/article/pii/S0870255116000676
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