title: Atrial Thrombus in a Premature Newborn Following Cardio-Pulmonary Resuscitation.
abstract: Critically ill newborns, whether term or preterm, are at great risk for developing symptomatic thromboembolic disease. Comorbidities like inflammation, DIC, fluctuations in cardiac output, congenital heart disease, as well as central venous or arterial catheters, are the predisposing risk factors. Clinically symptomatic or asymptomatic cases are usually picked up by echocardiography, usually done for other indications. Management usually comprises of observation, heparin therapy, thrombo-embolectomy, and catheter directed revascularization. We present a case of premature neonate who developed thrombus at inter-atrial septum as a possible consequence of cardiopulmonary resuscitation, detected by echocardiography. Conversely, there is always a possibility of paradoxical emboli in neonates with patent foramen ovale (PFO). Subsequent clinical course remained asymptomatic and baby was discharged home after 6 weeks with cardiac follow-up. Atrial septal findings of organized clot/thrombus in asymptomatic newborns need to be correlated with the details of neonatal care. Long-term follow-up is dependent on underlying pathology.
authors.affiliation: Department of Paediatrics and Child Health, The Aga Khan University Hospital, Karachi.
authors.forename: Syed Rehan
authors.initials: SR
authors.lastname: Ali
authors.affiliation: Department of Paediatrics and Child Health, The Aga Khan University Hospital, Karachi.
authors.forename: Shakeel
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Department of Paediatrics and Child Health, The Aga Khan University Hospital, Karachi.
authors.forename: Nadeem
authors.initials: N
authors.lastname: Aslam
authors.affiliation: Department of Paediatrics and Child Health, The Aga Khan University Hospital, Karachi.
authors.forename: Heeramani
authors.initials: H
authors.lastname: Lohana
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects*; D004452:Echocardiography; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006331:Heart Diseases / Q000175:diagnosis; D006801:Humans; D007231:Infant, Newborn; D013927:Thrombosis / Q000175:diagnosis*