Unusual intracardiac thrombosis in two patients with coronavirus disease 2019 (COVID-19): case series

Emiliano Calvi; Nicola Bernardi; Giuliana Cimino; Greta Pascariello; Pompilio Faggiano; Emanuele Gavazzi; Enrico Vizzardi; Marco Metra

doi:10.1093/ehjcr/ytaa518

Unusual intracardiac thrombosis in two patients with coronavirus disease 2019 (COVID-19): case series

Eur Heart J Case Rep. 2020 Dec 29;5(2):ytaa518. doi: 10.1093/ehjcr/ytaa518. eCollection 2021 Feb.

Authors

Emiliano Calvi¹, Nicola Bernardi¹, Giuliana Cimino¹, Greta Pascariello¹, Pompilio Faggiano¹, Emanuele Gavazzi², Enrico Vizzardi¹, Marco Metra¹

Affiliations

¹ Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Institute of Cardiology, University of Brescia, Brescia,Italy.
² Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Institute of Radiology, University of Brescia, Brescia,Italy.

Abstract

Background: COVID-19 may induce a coagulation dysregulation resulting in a prothrombotic state with a higher risk of arterial and venous thrombosis. This abnormal thrombotic diathesis can lead to pulmonary embolism, stroke, and intracardiac thrombosis.

Case summary: We present two cases of unusual intracardiac thrombosis in patients hospitalized for COVID-19. In both cases, imaging tests (such as transthoracic echocardiography (TTE), computed tomography scan of the chest, and cardiac magnetic resonance imaging) showed evidence of unusual intracardiac thrombosis with thrombi adherent to regularly contracting walls.

Discussion: This evidence confirms that COVID-19 induces a hypercoagulable state which can result in intracardiac thrombosis. Therefore, TTE is indicated in all COVID-19 patients for early diagnosis, and prompt anticoagulant therapy is to be considered as a thromboprophylaxis strategy.

Keywords: Anticoagulant; Case series; Coagulation; Thrombus; Transthoracic echocardiography.

Publication types

Case Reports