Merlo Enrico, Grutta Giuseppe, Tiberio Ivo, Martelli Gabriele
Intensive Care Unit "U.O.C. Anestesia e Rianimazione" Department of Medicine (DIMED) Padua University Hospital, Padua, Italy.
J Crit Care Med (Targu Mures). 2020 Nov 7;6(4):237-242. doi: 10.2478/jccm-2020-0039. eCollection 2020 Oct.
Right heart thrombus (RiHTh) can be considered a rare and severe condition associated with thromboembolic phenomena. A case is described of a COVID-19 patient presenting with an isolated thrombus in the right ventricle.
An 80-years-old Caucasian male was admitted in an intensive care unit (ICU) for COVID-19 related acute respiratory distress syndrome. The patient showed signs of hemodynamic instability, elevated cardiac troponin I and altered coagulation. On further assessment, a thrombotic mass near the apex of the right ventricle was detected. Moreover, the apex and the anteroseptal wall of the right ventricle appeared akinetic. Following the administration of a therapeutic dose of unfractionated heparin over a forty-eight hour period, re-evaluation of the right chambers showed that the thrombotic mass had resolved entirely.
COVID-19 patients could constitute a population at risk of RiHTh. Routine use of echocardiography and a multidisciplinary approach can improve the management of this condition.
右心血栓（RiHTh）可被视为一种与血栓栓塞现象相关的罕见且严重的病症。本文描述了一例新冠肺炎患者右心室孤立性血栓的病例。
一名80岁的白种男性因新冠肺炎相关的急性呼吸窘迫综合征入住重症监护病房（ICU）。患者表现出血流动力学不稳定、心肌肌钙蛋白I升高和凝血功能改变。进一步评估发现右心室心尖附近有一个血栓块。此外，右心室心尖和前间隔壁运动减弱。在48小时内给予治疗剂量的普通肝素后，对右心室腔的重新评估显示血栓块已完全消失。
新冠肺炎患者可能是发生RiHTh的高危人群。常规使用超声心动图和多学科方法可改善对此病症的管理。
