Lian Ping-An, Long Xia, Zhu Wen-Qiang, Huang Xian-Sheng
Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
Hospital Office, The Second Xiangya Hospital, Central South University, Changsha, China.
Front Cardiovasc Med. 2022 Jun 30;9:954850. doi: 10.3389/fcvm.2022.954850. eCollection 2022.
An isolated right atrial thrombus is a life-threatening entity that is extremely rare in patients with dilated cardiomyopathy (DCM), which is characterized by a reduced left ventricular function and consequent left ventricular thrombosis. Here, we present the case of a mysterious isolated giant right atrial thrombus in a male patient with DCM. The presence of deep vein thrombosis prompted us to investigate for other underlying diseases for his right atrial thrombus. Interestingly, the elevation of two tumor markers indicated the likelihood of cancer-associated thrombosis. Further, the computed tomography demonstrated a spiculated mass in the lower right lung that was confirmed by an endobronchial biopsy as lung squamous cell carcinoma. Consequently, the giant thrombus in the right atrium should be attributed principally to lung squamous cell carcinoma on the background of DCM. After 3 weeks of enoxaparin, the echocardiogram indicated partial resolution of the thrombus. However, the patient suffered sudden death due to pulmonary embolism.
孤立性右房血栓是一种危及生命的病症，在扩张型心肌病（DCM）患者中极为罕见，DCM的特征是左心室功能减退及随之而来的左心室血栓形成。在此，我们报告一例患有DCM的男性患者出现神秘的孤立性巨大右房血栓的病例。深静脉血栓形成的存在促使我们对其右房血栓的其他潜在病因进行调查。有趣的是，两种肿瘤标志物的升高提示了癌症相关血栓形成的可能性。此外，计算机断层扫描显示右下肺有一个毛刺状肿块，经支气管活检证实为肺鳞状细胞癌。因此，右心房的巨大血栓主要应归因于DCM背景下的肺鳞状细胞癌。使用依诺肝素3周后，超声心动图显示血栓部分溶解。然而，患者因肺栓塞猝死。
