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- W2121491941 abstract "Free-floating right atrial thrombi are rare but associated with high mortality. Although advances in echocardiography have improved diagnosis, their management is still the subject of debate. A 24-year-old woman with a history of smoking, obesity and oral contraceptive use presented to the emergency department with dyspnea, cough and hemoptysis. Transthoracic echocardiography revealed a large free-floating cardiac mass occupying the right atrial chamber and restricting tricuspid valve opening. In view of recurrent pulmonary embolism, she was referred for cardiac surgery and the cardiac mass was excised. Anatomopathological analysis revealed an organized and calcified thrombus. Genetic study showed her to be homozygous for the 4G/4G allelic variant of plasminogen activator inhibitor-1 and heterozygous for the allelic variant A1298C of 5,10-methylenetetrahydrofolate reductase. A presença de trombos móveis na aurícula direita são fenómenos raros, mas associados a uma elevada mortalidade. Apesar de a ecocardiorafia ter permitido avanços no seu diagnóstico a sua abordagem continua a ser motivo de debate. Neste artigo apresentamos o caso de uma doente do sexo feminino, de 24 anos com antecedentes de tabagismo, obesidade e sob terapêutica anovulatória que recorre ao serviço de urgência por cansaço fácil e tosse com expectoração hemoptóica. O ecocardiograma transtorácico revelou massa, móvel, multilobulada de grandes dimensões na aurícula direita, condicionando abertura da válvula tricúspide. Perante episódios recorrentes de embolia pulmonar foi submetida a cirurgia cardíaca com exérese da massa, sendo o resultado anatomopatológico compatível com trombo organizado com calcificação. O estudo genético revelou homozigotia para a variante alélica PAI-1:-675G >A (4G/4G) do inibidor do activador do plasminogénio e heterozigotia para a variante alélica MTHFR 1298 A/C da 5,10-metilenotetrahidrofolato redutase." @default.
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- W2121491941 date "2012-02-01" @default.
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- W2121491941 title "Right atrial thrombus: A rare presentation of plasminogen activator inhibitor deficiency" @default.
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- W2121491941 doi "https://doi.org/10.1016/j.repce.2011.09.005" @default.
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