Department of Internal Medicine, University of South Dakota, Sioux Falls, South Dakota.
Department of Cardiovascular Medicine, Sanford Hospital, Sioux Falls, South Dakota.
S D Med. 2022 Feb;75(2):62-64.
Coronavirus disease 2019 (COVID-19) has become a leading cause of morbidity and mortality worldwide. One of the major complications of COVID-19 infection is the hypercoagulability state. Cardiac thrombi and venous thromboembolism (VTE) have been documented with severe COVID-19 infection. We present a case of large right atrial (RA) thrombus in transit incidentally diagnosed following a mild COVID-19 in a previously vaccinated patient.
An 85-year-old male presented to the emergency department two weeks following resolution of a mild COVID-19 infection due to an incidentally discovered large RA thrombus. Computed tomography with angiography of the chest was positive for acute pulmonary thromboembolic disease with large clot burden and findings consistent with right heart strain. The patient remained hemodynamically stable and was successfully managed with anticoagulation.
RA thrombi and VTE can occur in patients with mild COVID-19 infection and in the setting of full COVID-19 vaccination. Echocardiography is a useful imaging modality in this patient population.
2019 年冠状病毒病（COVID-19）已成为全球发病率和死亡率的主要原因之一。COVID-19 感染的主要并发症之一是高凝状态。严重 COVID-19 感染已记录到心脏血栓和静脉血栓栓塞症（VTE）。我们报告了一例先前接种过疫苗的患者轻度 COVID-19 后偶然诊断出的大右心房（RA）游走性血栓形成。
一名 85 岁男性在轻度 COVID-19 感染痊愈两周后因偶然发现的大 RA 血栓形成而到急诊就诊。胸部 CT 血管造影术阳性，提示急性肺血栓栓塞症，血栓负荷大，右心劳损表现。患者血流动力学稳定，经抗凝治疗成功治疗。
RA 血栓和 VTE 可发生于轻度 COVID-19 感染患者和 COVID-19 疫苗完全接种的患者中。在这些患者人群中，超声心动图是一种有用的影像学检查方法。
