title: Massive chronic atrial thrombosis.
abstract: We report herein a patient in whom a very large and old thrombus in the left atrium was detected by transesophageal echocardiography. The patient started warfarin and aspirin. After 2 years of therapy, transesophageal echocardiography showed the complete resolution of thrombus in the absence of clinical evidence of embolism. This case indicates that large and presumably organized thrombi may be dissolved by an anticoagulant therapy, although the lytic activity of warfarin has never been demonstrated. Transesophageal echocardiography helps in the identification and follow-up of such conditions and contributes to understanding of warfarin action in left atrial thrombosis.
authors.affiliation: Department of Clinical Medicine and Cardiovascular and Immunological Sciences, Federico II University-School of Medicine, Via Pansini 5, 80131 Naples, Italy. losi@unina.it
authors.forename: Maria Angela
authors.initials: MA
authors.lastname: Losi
authors.forename: Paolo
authors.initials: P
authors.lastname: Golino
authors.forename: Sandro
authors.initials: S
authors.lastname: Betocchi
authors.forename: Massimo
authors.initials: M
authors.lastname: Ragni
authors.forename: Mariano
authors.initials: M
authors.lastname: Aversa
authors.forename: Massimo
authors.initials: M
authors.lastname: Chiariello
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use*; D002908:Chronic Disease; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D017548:Echocardiography, Transesophageal; D006325:Heart Atria; D006801:Humans; D008297:Male; D008875:Middle Aged; D014859:Warfarin / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D001241:Aspirin