Division of Cardiology Mount Sinai Hospital, New York, New York.
Department of Internal Medicine, Mount Sinai Beth Israel Hospital Center, Academic Affiliate of the Icahn School of Medicine at Mount Sinai, Clinical Affiliate of the Mount Sinai Hospital, New York, New York.
Am J Med Sci. 2018 Jun;355(6):610-613. doi: 10.1016/j.amjms.2017.10.005. Epub 2017 Dec 27.
Thrombus in the heart is known to be one of the many sequelae of anterior wall myocardial infarction, atrial fibrillation and coagulation disorders. However, biventricular thrombi are relatively rarely found, even in conditions with a high possibility of thrombus formation. We report the case of a 75-year-old-woman with newly diagnosed systolic heart failure secondary to a nonischemic cardiomyopathy, who was found to have large biventricular thrombi. Further coagulopathy work-up revealed that she was heterozygous for the prothrombin 20210G/A and homozygous for the methylenetetrahydrofolate reductase (MTHFR) 677C/T mutations. We, herein, review and discuss previous case reports and published literature regarding ventricular thrombosis and its treatment. To the best of our knowledge, this is the first case of biventricular thrombosis with prothrombin 20210G/A and MTHFR 677C/T mutations.
心脏血栓是前壁心肌梗死、心房颤动和凝血障碍等多种后遗症之一。然而，双心室血栓相对较少见，即使在血栓形成可能性较高的情况下也是如此。我们报告了一例 75 岁女性新诊断的非缺血性心肌病引起的收缩性心力衰竭，发现其存在大的双心室血栓。进一步的凝血功能障碍检查显示，她携带凝血酶原 20210G/A 杂合突变和亚甲基四氢叶酸还原酶（MTHFR）677C/T 纯合突变。在此，我们回顾并讨论了以前关于心室血栓形成及其治疗的病例报告和文献。据我们所知，这是首例伴有凝血酶原 20210G/A 和 MTHFR 677C/T 突变的双心室血栓形成病例。
