Cor Vasa 2014, 56(5):e417-e419 | DOI: 10.1016/j.crvasa.2013.10.006

Moderate rheumatic mitral stenosis complicated by massive thrombus formation

Jana Čepelová^a,*, Jan Škvařil^a, Josef Bešík^b, Tomáš Marek^b, Eva Krčová^a, Jan Pirk^b, Martin Malý^a

^a Kardiologické oddělení, Interní klinika, 1. lékařská fakulta Univerzity Karlovy a Ústřední vojenská nemocnice, Praha, Česká republika

^b Klinika kardiochirurgie, Institut klinické a experimentální medicíny, Praha, Česká republika

Advanced rheumatic mitral stenosis with enlarged left atrium and atrial fibrillation can predispose to the formation of thrombi over time, if anticoagulation treatment is ineffective. We present the case of a 66-year-old woman with atrial fibrillation and syncope. Moderate rheumatic mitral stenosis was diagnosed by echocardiography and two huge thrombi were incidentally revealed within the enlarged left atrium. CT scan of the brain did not demonstrate cerebral ischemia. The patient underwent early mitral valve replacement surgery and extirpation of the thrombotic masses. A pacemaker was implanted because of symptomatic bradyarrhythmia.

Keywords: Cardiac tumor; Left atrium; Rheumatic mitral stenosis; Thrombus

Received: July 4, 2013; Revised: October 14, 2013; Accepted: October 26, 2013; Published: October 1, 2014  Show citation