Images in cardiovascular medicine. Mobile left atrial thrombus associated with mitral stenosis.

Abstract

HomeCirculationVol. 98, No. 9Mobile Left Atrial Thrombus Associated With Mitral Stenosis Free AccessOtherPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyRedditDiggEmail Jump toFree AccessOtherPDF/EPUBMobile Left Atrial Thrombus Associated With Mitral Stenosis G. R. Wright-Smith, D. J. Burstow, R. Seymour, C. Smith and M. F. O’Brien G. R. Wright-SmithG. R. Wright-Smith From The Prince Charles Hospital, Brisbane, Queensland, Australia, Departments of Cardiology and Cardiothoracic Surgery. Search for more papers by this author , D. J. BurstowD. J. Burstow From The Prince Charles Hospital, Brisbane, Queensland, Australia, Departments of Cardiology and Cardiothoracic Surgery. Search for more papers by this author , R. SeymourR. Seymour From The Prince Charles Hospital, Brisbane, Queensland, Australia, Departments of Cardiology and Cardiothoracic Surgery. Search for more papers by this author , C. SmithC. Smith From The Prince Charles Hospital, Brisbane, Queensland, Australia, Departments of Cardiology and Cardiothoracic Surgery. Search for more papers by this author and M. F. O’BrienM. F. O’Brien From The Prince Charles Hospital, Brisbane, Queensland, Australia, Departments of Cardiology and Cardiothoracic Surgery. Search for more papers by this author Originally published1 Sep 1998https://doi.org/10.1161/01.CIR.98.9.931Circulation. 1998;98:931–932A68-year-old woman presented with a 6-week history of shortness of breath on exertion. She had longstanding mitral stenosis and atrial fibrillation and was not taking oral anticoagulants.Thirty years previously, she reportedly had had a stroke and made a full recovery. Transthoracic echocardiography (Figure 1) demonstrated a freely mobile mass in the left atrium associated with severe mitral stenosis and mild aortic stenosis. The mass bounced around the atrium like a ball in a pinball machine.At surgery, a large, unattached, completely smooth, circular thrombus (Figures 2 and 3) was removed, and the patient had a mitral valve replacement and aortic valvotomy. The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke’s Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1–267, Houston, TX 77030.Download figureDownload PowerPoint Figure 1. Transthoracic echocardiogram showing a large, ball-shaped mass, with an echolucent center, that was freely mobile within the left atrial cavity. The mitral valve was thickened and calcified, and Doppler hemodynamics demonstrated severe mitral stenosis with a valve area of 0.8 cm2 and moderate left atrial dilatation.Download figureDownload PowerPoint Figure 2. At surgery, the mass was not adherent to the atrial wall and was easily removed from the left atrium.Download figureDownload PowerPoint Figure 3. Cut section of the mass revealed laminated thrombus, giving an onionskin appearance with central cavitation.FootnotesCorrespondence to G.R. Wright-Smith, The Prince Charles Hospital, Department of Cardiology, Rode Road, Chermside, Queensland, 4032, Australia. Previous Back to top Next FiguresReferencesRelatedDetails September 1, 1998Vol 98, Issue 9Article InformationMetrics Copyright © 1998 by American Heart Associationhttps://doi.org/10.1161/01.CIR.98.9.931 Originally publishedSeptember 1, 1998 PDF download Advertisement