title: Thrombi in all four cardiac chambers in a patient with an old anteroseptal myocardial infarction and atrial flutter.
abstract: Cases with thrombi in multiple cardiac chambers are rare. We report an extremely rare case in which thrombi were formed in all four cardiac chambers at the same time. A 55-year-old man presented with biventricular failure and liver dysfunction. A 12-lead ECG and an echocardiogram revealed an old anteroseptal myocardial infarction with aneurysm formation and atrial flutter. A transesophageal echocardiogram and a CT of the chest revealed thrombi in the right and left atrial appendage, right ventricular apex and left ventricular aneurysm. Pulmonary emboli were also identified. Stasis of the blood due to ventricular dysfunction and atrial flutter was considered to be responsible. The patient died of multiorgan failure due to circulatory failure.
authors.affiliation: Department of Internal Medicine, Okinawa Chubu Hospital, Uruma City, Okinawa, Japan.
authors.forename: Hanae
authors.identifier: http://orcid.org/0000-0002-8705-7143
authors.initials: H
authors.lastname: Ida
authors.affiliation: Department of Cardiology, Okinawa Chubu Hospital, Uruma City, Okinawa, Japan.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Hirata
authors.affiliation: Department of Cardiology, Okinawa Chubu Hospital, Uruma City, Okinawa, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Takahashi
authors.affiliation: Department of Internal Medicine, Okinawa Chubu Hospital, Uruma City, Okinawa, Japan.
authors.forename: Takanobu
authors.initials: T
authors.lastname: Hirosawa
mesh_terms: D056988:Anterior Wall Myocardial Infarction / Q000150:complications* / Q000175:diagnosis; D001282:Atrial Flutter / Q000150:complications* / Q000175:diagnosis; D017809:Fatal Outcome; D006331:Heart Diseases / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013927:Thrombosis / Q000175:diagnosis* / Q000209:etiology