title: [Recurrent right atrial thrombus in a patient with atrial fibrillation and heart failure].
abstract: Atrial fibrillation and heart failure are factors predisposing to locally formed intracardiac thrombosis, which is usually localized in left-sided chambers. A case report. The authors present a case of a 50-year-old male with permanent atrial fibrillation and dilated cardiomyopathy in whom recurrent right atrial thrombus was observed. Initially, the lesion was detected in echocardiography while he was hospitalized due to extensive right-sided pneumonia. The thrombus was successfully treated with heparin, followed by warfarin. Even though the patient continued warfarin use properly, there was recurrence of the thrombus two years later during a new episode of heart failure exacerbation. Because the thrombus was resistant to intensified anticoagulation, cardiac surgery was needed. A large (30 x 25 mm) pedunculated thrombus, as well as two smaller ones (each of 10 x 10 mm) attached closely to the atrial wall and previously not detected either by echocardiography or by magnetic resonance imaging, were excited. A partially organized pattern of the thrombi in histological examination can explain lack of anticoagulation effectiveness.
authors.affiliation: Józef Struś Hospital, Poznań, Poland: Department of Internal Medicine.
authors.forename: Waldemar
authors.initials: W
authors.lastname: Elikowski
authors.affiliation: Józef Struś Hospital, Poznań, Poland: Department of Internal Medicine.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Wróblewski
authors.affiliation: University of Medical Sciences, 2nd Department of Cardiology, Poznań, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Małek-Elikowska
authors.affiliation: Józef Struś Hospital, Poznań, Poland: Department of Cardiac Surgery.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Mazurek
authors.affiliation: Józef Struś Hospital, Poznań, Poland: Department of Cardiology.
authors.forename: Joanna
authors.initials: J
authors.lastname: Foremska-Iciek
authors.affiliation: Józef Struś Hospital, Poznań, Poland: Pathomorphology Unit.
authors.forename: Stanisław
authors.initials: S
authors.lastname: Łazowski
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications*; D002311:Cardiomyopathy, Dilated / Q000150:complications*; D004452:Echocardiography; D006325:Heart Atria / Q000000981:diagnostic imaging; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D006333:Heart Failure / Q000209:etiology*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D006493:Heparin
keywords: atrial fibrillation; heart failure; recurrent thrombus; right atrium