Incidental Finding of a Right Atrial Appendage Thrombus in a Patient With Dilated Cardiomyopathy and Diffuse B-cell Lymphoma

Right atrial thrombus is a rare phenomenon linked with a high risk of mortality. We present a case of a 75-year-old male with dilated cardiomyopathy and B-cell lymphoma on chemotherapy via an implanted chemo port who presented with dyspnea secondary to new-onset atrial flutter. During the evaluation...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2024-10, Vol.16 (10), p.e71381
Main Authors: Rana, Aakash, Xu, Jack, Manam, Rupesh
Format: Article
Language:English
Subjects:
Blood clots
Cancer therapies
Cardiac arrhythmia
Cardiology
Cardiomyopathy
Cardiovascular disease
Catheters
Chemotherapy
Creatinine
Dyspnea
Edema
Electrocardiography
Emergency medical care
Heart
Hospice care
Hypertension
Internal Medicine
Lymphoma
Magnetic resonance imaging
Oncology
Patients
Pulmonary embolisms
Remission (Medicine)
Risk factors
Thromboembolism
Thrombosis
Ultrasonic imaging
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Summary:Right atrial thrombus is a rare phenomenon linked with a high risk of mortality. We present a case of a 75-year-old male with dilated cardiomyopathy and B-cell lymphoma on chemotherapy via an implanted chemo port who presented with dyspnea secondary to new-onset atrial flutter. During the evaluation for new-onset atrial flutter, a thrombus in the right atrial appendage was incidentally found on transesophageal echocardiogram (TEE). This finding was confirmed with cardiac magnetic resonance imaging. A multidisciplinary heart team evaluation was performed, and the patient was deemed not a surgical candidate. The patient was discharged on apixaban for the right atrial thrombus treatment and later deferred to hospice care. This case highlights that there are no formal guidelines for managing right atrial thrombi (RAT), but treatment options include anticoagulation, thrombolytic therapy, and surgical thrombectomy or embolectomy with vacuum extraction. Additional research is needed to develop appropriate guidelines for management and prevent further systematic complications.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.71381