[Right atrial thrombus: a rare presentation of plasminogen activator inhibitor deficiency].
Free-floating right atrial thrombi are rare but associated with high mortality. Although advances in echocardiography have improved diagnosis, their management is still the subject of debate. A 24-year-old woman with a history of smoking, obesity and oral contraceptive use presented to the emergency department with dyspnea, cough and hemoptysis. Transthoracic echocardiography revealed a large free-floating cardiac mass occupying the right atrial chamber and restricting tricuspid valve opening. In view of recurrent pulmonary embolism, she was referred for cardiac surgery and the cardiac mass was excised. Anatomopathological analysis revealed an organized and calcified thrombus. Genetic study showed her to be homozygous for the 4G/4G allelic variant of plasminogen activator inhibitor-1 and heterozygous for the allelic variant A1298C of 5,10-methylenetetrahydrofolate reductase.
Serviço de Cardiologia, Hospital do Espírito Santo, Évora, Portugal. bcpicarra@hotmail.com
Bruno
B
Cordeiro Piçarra
Ana Rita
AR
Santos
Pedro
P
Dionísio
João
J
Vasconcelos
Nuno
N
Banazol
Sílvia
S
Lourenço
Fátima
F
Caetano
António
A
Jara
D005260:Female; D006325:Heart Atria; D006331:Heart Diseases / Q000209:etiology*; D006801:Humans; D017395:Plasminogen Activator Inhibitor 1 / Q000172:deficiency*; D013927:Thrombosis / Q000209:etiology*; D055815:Young Adult
D017395:Plasminogen Activator Inhibitor 1