Right Atrial Thrombus Mimicking a Myxoma: Synergism of Hormonal Contraceptives and Antiphospholipid Antibodies.

Antibodies, antiphospholipid/blood antiphospholipid syndrome/complications/diagnosis autoantibodies/analysis diagnosis, differential heart atria heart diseases/diagnosis/etiology thrombosis/diagnostic imaging/etiology treatment outcome

Journal

Texas Heart Institute journal
ISSN: 1526-6702
Titre abrégé: Tex Heart Inst J
Pays: United States
ID NLM: 8214622

Informations de publication

Date de publication:
01 07 2022
Historique:
entrez: 8 8 2022
pubmed: 9 8 2022
medline: 11 8 2022
Statut: ppublish

Résumé

Cardiac thrombus, the most common intracardiac mass, is typically seen in the left side of the heart in the presence of atrial fibrillation, mitral stenosis, or impaired global wall motion. Right atrial thrombus, which is rarer, is usually associated with central venous catheter placement or pulmonary embolism. We present the case of a 24-year-old woman with a history of mitral valve prolapse who presented with fatigue and palpitations. Echocardiograms and cardiac magnetic resonance images revealed a right atrial mass compatible with a myxoma. However, after surgical excision of this and a second mass discovered intraoperatively, pathologic evaluation confirmed organized thrombus rather than myxoma. The patient's only risk factor was her use of oral contraceptive pills. Test results for hypercoagulable disorders revealed the presence of antiphosphatidylserine, an uncommon antiphospholipid antibody. The patient stopped taking the contraceptive. This case suggests the need to examine further the role of antiphosphatidylserine antibodies in the diagnosis of antiphospholipid syndrome.

Identifiants

pubmed: 35939276
pii: 484540
doi: 10.14503/THIJ-20-7455
pmc: PMC9427053
pii:
doi:

Substances chimiques

Antibodies, Antiphospholipid 0
Contraceptive Agents 0

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2022 by the Texas Heart® Institute, Houston.

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Auteurs

Zeba Hashmath (Z)

Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts.

Abhishek Bose (A)

Division of Cardiology, Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts.

Ramses Thabet (R)

Division of Cardiology, Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts.

Ajay K Mishra (AK)

Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts.

Mark Kranis (M)

Division of Cardiology, Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts.

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Classifications MeSH