Right atrium thrombus in the presence of an atrial septal defect: a case report
https://doi.org/10.15829/1728-8800-2023-3614
EDN: GSPHQZ
Abstract
Introduction. Right atrial (RA) masses have a very different origin. They may be clots. Most often, thrombi from the inferior vena cava migrate to RA. At the same time, an isolated thrombus in RA is a rare finding.
Brief description. The article presents a case of detection of a round mass in RA in combination with an atrial septal defect. The mass was discovered by chance during a cardiac ultrasound in a 71-year-old female patient who applied due to hypertension. Accurate determination of the mass structure was possible only after its removal and histological analysis. It turned out to be an organized thrombus with cystic degeneration.
Discussion. When a volumetric formation in the RA cavity is detected, a differential diagnosis of a thrombus with primary benign (myxoma or fibroelastoma) and malignant (sarcoma, lymphoma) tumors, metastases, which are found much more often than with primary cardiac tumors. The case is of interest due to thrombus location in RA region without inferior vena cava thrombosis, in combination with an atrial septal defect. This could contribute not only to pulmonary artery embolism, but also cause a paradoxical embolism in systemic circulation vessels.
About the Authors
S. A. Chepurnenko
Rostov State Medical University;
Rostov Regional Clinical Hospital
Russian Federation
Russian Federation
Svetlana A. Chepurnenko
Rostov-on-Don
G. V. Shavkuta
Rostov State Medical University
Russian Federation
Russian Federation
Galina V. Shavkuta
Rostov-on-Don
A. A. Demidova
Rostov State Medical University
Russian Federation
Russian Federation
Anna A. Demidova
Rostov-on-Don
References
1. Isaev GO, Mironova OYu, Yudakova ME, et al. Metastatic lesion of the right atrium with renal cell carcinoma. Therapeutic Archive. 2019;91(9):124-8. (In Russ.) doi:10.26442/00403660.2019.09.000218.
2. Konradi YuV, Ryzhkova DV. Cardiac tumors imaging. Translational Medicine. 2015;(4):28-40. (In Russ.) doi:10.18705/2311-4495-2015-0-4-28-40.
3. Zheltovskiy YV, Batekha VI, Podkamenniy VA, et al. Diagnosis and treatment of cardiac myxoma. Acta Biomed Sci. 2017;2(6):21-6. (In Russ.) doi:10.12737/article_5a0a7ef348ea58.75839252.
4. Tarasevich SV, Galitskaya SS, Kozlov OI, et al. A Clinical Case of "Serpentine" Thrombus in the Right Atrium from the Inferior Vena Cava: A Rare Finding on Echocardiography. Cardiology in Belarus. 2022;14(5):666-72. (In Russ.) doi:10.34883/pi.2022.14.5.012.
5. Bosman NAM, Kuipers RS. Case report of a "snake thrombus" in the right heart: a rare finding one chocardiography. Eur Heart J Case Rep. 2020;4(6):16. doi:10.1093/ehjcr/ytaa424.
6. Andreeva AE, Bartosh-Zelenaya SYu, Novikov VI, et al. Formation of the right heart chambers in norm and pathology. Cardiology: News, Opinions, Training. 2021;9(1):70-82. (In Russ.) doi:10.33029/2309-1908-2021-9-1-70-82.
7. Ioannidis SG, Mitsias PD. Patent Foramen Ovale in Cryptogenic Ischemic Stroke: Direct Cause, Risk Factor, or Incidental Finding? Front Neurol. 2020;11:567. doi:10.3389/fneur.2020.00567.
8. Wahl A, Krumsdorf U, Meier B, et al. Transcatheter treatment of atrial septal aneurysm associated with patent foramen ovale for prevention of recurrent paradoxical embolism in high-risk patients. J Am Coll Cardiol. 2005;45(3):377-80. doi:10.1016/j.jacc.2004.10.043.
9. Cho K, Feneley M, Holloway C. Atrial Septal Aneurysms — A Clinically Relevant Enigma? Heart Lung Circ. 2022;31(1):17-24. doi:10.1016/j.hlc.2021.07.025.
10. Sotnikov AV, Melnikov MV, Ivanova VF, et al. Pathogenesis of embologenic thrombosis of the left atrium in patients with atrial fibrillation. Card. and Cardiovasc. Surg. 2021;14(5):400-6. (In Russ.) doi:10.17116/kardio202114051400.
Supplementary files
- A female patient with an atrial septal defect had a round mass in the right atrial cavity. After surgery with its removal and biopsy, an organized thrombus with cystic degeneration was found. The causes of thrombus formation in the right atrium could be lower limb vein thrombosis in the past, atrial septal aneurysm with a defect, as well as atrial fibrillation.
Review
For citations:
Chepurnenko S.A., Shavkuta G.V., Demidova A.A. Right atrium thrombus in the presence of an atrial septal defect: a case report. Cardiovascular Therapy and Prevention. 2023;22(8):3614. (In Russ.) https://doi.org/10.15829/1728-8800-2023-3614. EDN: GSPHQZ
Views:
4039
Email this article 
