Cardiac thrombi in a patient with protein-C and S deficiencies: a case report

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Cardiac thrombi in a patient with protein-C and S deficiencies: a case report

Publisher
BioMed Central
Publication Date
Mar 28, 2004
Source
PMC
Keywords
Disciplines
  • Biology
  • Medicine
License
Unknown

Abstract

1477-9560-2-2.fm ral ss BioMed CentThrombosis Journal Open AcceCase report Cardiac thrombi in a patient with protein-C and S deficiencies: a case report Ertugrul Ercan*1, Istemihan Tengiz1, Cevad Sekuri2, Fahri Sahin3, Emil Aliyev1, Mustafa Akin4 and Unal Ac kel1 Address: 1Cardiology Department, Central Hospital, 1644 Sk No:2/2 35010 Bayrakli/Izmir, Turkey, 2Cardiology Department, Kent Hospital, Cigli/ Izmir, Turkey, 3Hematology Department, Ege University Medical School, 35100 Bornova/Izmir, Turkey and 4Cardiology Department, Ege University Medical School, 35100 Bornova/Izmir, Turkey Email: Ertugrul Ercan* - [email protected]; Istemihan Tengiz - [email protected]; Cevad Sekuri - [email protected]; Fahri Sahin - [email protected]; Emil Aliyev - [email protected]; Mustafa Akin - [email protected]; Unal Ac kel - [email protected] * Corresponding author Abstract We report a case of multiple mobile intra-cardiac thrombi accompanying recurrent pulmonary embolism that has been successfully treated by fibrinolytic therapy. Control transesophageal echocardiographic examination showed that prolonged thrombolytic treatment completely removed the thrombi. Surgical removal of emboli has been validated but cannot be proposed to all patients since it is a high-risk interven- tion. Fibrinolysis is generally efficient but exposes the patient to risk of migration of the intra-cavity thrombus, with occasionally deleterious evolution. Systemic throm- bolytic therapy is usually recommended if (a) it is not contraindicated and (b) the thrombi are demonstrated in more than one cardiac chamber, entailing a higher risk of surgical intervention. However, the infusion rate and duration of thrombolytic therapy are important determi- nants of successful and uncomplicated lysis. Low dose and long infusion time should be chosen to avoid frag- mentation of the thrombus and related complications. Case A 56-year-old man was admitted to our hospital with chest pain and s

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