Advertisement
Clinical Communications: Adult|Articles in Press

CASE STUDY OF BIATRIAL THROMBUS: FOUND DOWN WITH ATRIAL FIBRILLATION

Published:February 28, 2023DOI:https://doi.org/10.1016/j.jemermed.2023.02.014

      Abstract

      Background

      Biatrial thrombus is a rare condition that is typically associated with a patent foramen ovale (PFO).

      Case Report

      This is a case of a 75-year-old man with history of heavy alcohol use found down with altered sensorium. He was hypothermic and in atrial fibrillation with rapid ventricular rate and was subsequently found to have a biatrial thrombus with no evidence of PFO. Why Should an Emergency Medicine Physician Be Aware of This? Biatrial thrombus presents the unique danger of progressing to both pulmonary embolus and acute embolic disease (including stroke); both are life-threatening diagnoses that can be prevented by means of identifying and treating this rare and dangerous condition.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Emergency Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      REFERENCES

        • Martin SS
        Biatrial thrombus across a patent foramen ovale with fatal pulmonary and coronary embolism.
        J Echocardiogr. 2012; 10: 77-78
        • Aksu HÜ
        • Ertürk M
        • Gül M
        • Uslu N
        Successful treatment of a patient with pulmonary embolism and biatrial thrombus.
        Anadolu Kardiyol Derg. 2013; 13: 199
        • Aboukhoudir F
        • Najjar A
        • Moussa K
        • Habib G
        • Pankert M
        • Rekik S
        A thrombus on a journey: a massive thrombus in transit with cerebral, coronary, and pulmonary embolization.
        Can J Cardiol. 2021; 37: 1281-1282
        • Görenek B
        • Çavus̈oǧlu Y
        • Timuralp B
        • Ata N
        • Ünalir A
        • Dokumaci B
        Case of biatrial thrombosis.
        Echocardiography. 1998; 15: 587-590
        • Schaefer A
        • Treede H
        • Reichenspurner H
        • Conradi L
        Large biatrial thrombembolus caught in transit across a patent foramen ovale.
        Thorac Cardiovasc Surg Rep. 2015; 4: 44-45
        • Kathir K
        Communicating massive biatrial thrombus.
        Intern Med J. 2003; 33: 471-472
        • Nugara C
        • Lo Voi A
        • Diana D
        • Sarullo S
        • Zarcone A
        • Sarullo FM
        A case of extensive biatrial clot straddling the patent foramen ovale.
        Monaldi Arch Chest Dis. 2021; 91
        • Derviş E
        • Aktaş M
        • Bozyel S
        • Yavuz Ş
        • Şahin T
        A large biatrial thrombus entrapped by patent foramen ovale in a case with massive pulmonary embolism.
        Turk Gogus Kalp Damar Cerrahisi Derg. 2018; 26: 150-152
        • Sattar A
        • Win TT
        • Schevchuck A
        • Achrekar A
        Extensive biatrial thrombus straddling the patent foramen ovale and traversing into the left and right ventricle.
        BMJ Case Rep. 2016; 2016https://doi.org/10.1136/BCR-2016-216761
        • Brickner ME
        • Friedman DB
        • Cigarroa CG
        • Grayburn PA
        Relation of thrombus in the left atrial appendage by transesophageal echocardiography to clinical risk factors for thrombus formation.
        Am J Cardiol. 1994; 74: 391-393
        • Agmon Y
        • Khandheria BK
        • Gentile F
        • Seward JB
        Clinical and echocardiographic characteristics of patients with left atrial thrombus and sinus rhythm experience in 20 643 consecutive transesophageal echocardiographic examinations.
        Circulation. 2002; 105: 27-31
        • Turgut O
        • Yalta K
        • Yilmaz MB
        • Dizman R
        • Tandogan I
        Free-floating biatrial thrombi with concomitant saddle pulmonary embolism.
        Int J Cardiol. 2010; 144: e11-e13https://doi.org/10.1016/j.ijcard.2008.12.035
        • Windecker S
        • Stortecky S
        • Meier B
        Paradoxical embolism.
        J Am Coll Cardiol. 2014; 64: 403-415
        • Elias P
        • Nunez Berton JD
        • Calfa MT
        • Radfar A
        Case report: a rare case of biatrial thrombus in the absence of interatrial shunt.
        Clin Med Rev Case Rep. 2021; 8: 356https://doi.org/10.23937/2378-3656/1410356
        • Arslan S
        • Sevimli S
        • Gundogdu F
        Fatal biatrial thrombus in a patient with idiopathic restrictive cardiomyopathy during sinus rhythm.
        Int J Cardiol. 2007; 117: e68-e70https://doi.org/10.1016/j.ijcard.2006.11.141
        • Myers PO
        • Bounameaux H
        • Panos A
        • Lerch R
        • Kalangos A
        Impending paradoxical embolism: systematic review of prognostic factors and treatment.
        Chest. 2010; 137: 164-170
        • Seo WW
        • Kim SE
        • Park MS
        • et al.
        Systematic review of treatment for trapped thrombus in patent foramen ovale.
        Korean Circ J. 2017; 47: 776
        • Baydoun H
        • Barakat I
        • Hatem E
        • Chalhoub M
        • Mroueh A
        Thrombus in transit through patent foramen ovale.
        Case Rep Cardiol. 2013; 2013: 1-4
        • Wrisley D
        • Giambartolomei A
        • Lee I
        • Brownlee W
        • Syracuse R
        Left atrial ball thrombus: review of clinical and echocardiographic manifestations with suggestions for management.
        Am Heart J. 1991; 121: 1784-1790