Right atrial thrombus in a patient with COVID-19 pneumonia: a case report. Issue Volume 4:Issue FI1(2020)Special Issue (4th September 2020)

• Record Type: Journal Article
• Authors: Shamsah, Mohammed A; Bitar, Zouheir Ibrahim; Alfoudri, Huda
• Editors: Tan, Timothy C; Christoph, Sinning; Max, Sayers; Thomson, Ross
• Is Part Of: European heart journal. Volume 4:Issue FI1(2020)Special Issue
• Page Start: 1
• Page End: 4
• Publication Date: 2020-09-04
• Subjects: Case report -- COVID-19 -- Pneumonia -- Thrombosis -- Pulmonary embolism; Cardiology -- Periodicals; Cardiology -- Case studies -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Diseases -- Case studies -- Periodicals; 616.12
• DOI: 10.1093/ehjcr/ytaa296
• Languages: English
• ISSNs: 2514-2119

Abstract

Abstract: Background: Significant coagulopathy and hyperinflammation are found in patients with coronavirus disease 2019 (COVID-19). Expert consensus has recommended prophylactic anticoagulation in COVID-19 patients due to the risk of thrombo-embolism. However, the use of therapeutic anticoagulation in these patients is still a matter of debate. Case summary: We describe a patient with COVID-19 pneumonia and a clinical hyperinflammatory state. He developed early respiratory depression and required ventilation, and he subsequently developed haemodynamic instability. Point-of-care echocardiography demonstrated a right atrial thrombus and right ventricular dysfunction suggestive of acute massive pulmonary embolism. He was managed with veno-arterial extracorporeal membrane oxygenation and local thrombolysis. Discussion: Critical cases of COVID-19 pneumonia are associated with hypercoagulation, and these patients should be monitored closely for complications. Therapeutic anticoagulation may play a role in the management and prevention of thrombo-embolism.