Resolution of Left Ventricular Thrombus Secondary to Tachycardia-induced Heart Failure with Rivaroxaban

Overview

Journal Case Rep Med

Publisher Wiley

Specialty General Medicine

Date 2014 Dec 6

PMID 25477972

Citations 17

Authors

Kosuke Nakasuka

Shigenori Ito

Tsubasa Noda

Takahiro Hasuo

Satoru Sekimoto

Hiroyuki Ohmori

Masahiko Inomata

Takayuki Yoshida

Nozomu Tamai

Tomoaki Saeki

Shin Suzuki

Yoshimasa Murakami

Koichi Sato

Affiliations

Soon will be listed here.

Abstract

A 42-year-old man was admitted to our hospital because of lumbago and tachycardia-induced heart failure. Transthoracic echocardiography revealed impaired left ventricular function and a ball mass of thrombus in the left ventricle (LV). He was found to have systemic embolism in the spleen, kidneys, brain, and limbs. The patient was treated with limb thrombectomy followed by anticoagulation. Seven days after the direct factor Xa inhibitor, rivaroxaban, was initiated, transthoracic echocardiography was repeated, revealing disappearance of the LV thrombus without any clinical signs of cardiogenic embolism. His heart failure responded well and the LV wall motion had improved. This case suggests rivaroxaban has fibrinolytic effects on thrombi even in the LV.

Citing Articles

Incessant atrioventricular nodal reentrant tachycardia resulting in tachycardia-induced cardiomyopathy and catastrophic embolization of left ventricular thrombus.

Taoutel R, Sukhon F, Liskov S, Kreidieh B, Chandhok S HeartRhythm Case Rep. 2023; 9(3):144-147.

PMID: 36970383 PMC: 10030302. DOI: 10.1016/j.hrcr.2022.11.015.

Anticoagulation for Left Ventricle Thrombus-Case Series and Literature Review for Use of Direct Oral Anticoagulants.

Pradhan A, Bhandari M, Vishwakarma P, Salimei C, Iellamo F, Sethi R J Cardiovasc Dev Dis. 2023; 10(2).

PMID: 36826537 PMC: 9962157. DOI: 10.3390/jcdd10020041.

Direct Oral Anticoagulants for Stroke and Systemic Embolism Prevention in Patients with Left Ventricular Thrombus.

Badescu M, Sorodoc V, Lionte C, Ouatu A, Haliga R, Costache A J Pers Med. 2023; 13(1).

PMID: 36675819 PMC: 9866081. DOI: 10.3390/jpm13010158.

Multiple, left ventricular cystic thrombi disappeared in 14 days.

Asarcikli L, Sahan H, Pamukcu H, Sunman H Anatol J Cardiol. 2021; 25(8):E31.

PMID: 34369892 PMC: 8357432. DOI: 10.5152/AnatolJCardiol.2021.26796.

A Giant Left Intraventricular Thrombus Associated With Apical Hypertrophic Cardiomyopathy Mimics Cancer.

Raza N, Burnette S, Joolhar F, Ghandforoush A, Win T Cureus. 2021; 13(6):e15554.

PMID: 34123682 PMC: 8189833. DOI: 10.7759/cureus.15554.

References

Flierl U, Fraccarollo D, Micka J, Bauersachs J, Schafer A . The direct factor Xa inhibitor Rivaroxaban reduces platelet activation in congestive heart failure. Pharmacol Res. 2013; 74:49-55. DOI: 10.1016/j.phrs.2013.05.002. View

Selvanayagam J, Spyrou N, Francis J, Neubauer S . Resolution of ventricular thrombus identified by contrast enhanced cardiac MRI. Int J Cardiovasc Imaging. 2005; 20(5):369-70. DOI: 10.1023/b:caim.0000041942.74669.e2. View

Vidal A, Vanerio G . Dabigatran and left atrial appendage thrombus. J Thromb Thrombolysis. 2012; 34(4):545-7. DOI: 10.1007/s11239-012-0747-1. View

Potu C, Tulloch-Reid E, Baugh D, Madu E . Left ventricular thrombus in patients with acute myocardial infarction:Case report and Caribbean focused update. Australas Med J. 2012; 5(3):178-83. PMC: 3422718. DOI: 10.4066/AMJ.20121103. View

Nagamoto Y, Shiomi T, Matsuura T, Okahara A, Takegami K, Mine D . Resolution of a left ventricular thrombus by the thrombolytic action of dabigatran. Heart Vessels. 2013; 29(4):560-2. DOI: 10.1007/s00380-013-0403-5. View

Yeh C, Fredenburgh J, Weitz J . Oral direct factor Xa inhibitors. Circ Res. 2012; 111(8):1069-78. DOI: 10.1161/CIRCRESAHA.112.276741. View

Takasugi J, Yamagami H, Okata T, Toyoda K, Nagatsuka K . Dissolution of the left atrial appendage thrombus with rivaroxaban therapy. Cerebrovasc Dis. 2013; 36(4):322-3. DOI: 10.1159/000354315. View

Sobanski P, Gilewski W, Sledz J, Klank-Szafran M, Stec S, Zagrodzka M . [Severe tachycardiomyopathy and thrombus in the left atrial appendage--a case report]. Kardiol Pol. 2011; 69(3):294-7. View

Connolly S, Ezekowitz M, Yusuf S, Eikelboom J, Oldgren J, Parekh A . Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009; 361(12):1139-51. DOI: 10.1056/NEJMoa0905561. View

10.

Fuster V, Ryden L, Cannom D, Crijns H, Curtis A, Ellenbogen K . 2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 Guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice.... J Am Coll Cardiol. 2011; 57(11):e101-98. DOI: 10.1016/j.jacc.2010.09.013. View

11.

Hammerstingl C, Potzsch B, Nickenig G . Resolution of giant left atrial appendage thrombus with rivaroxaban. Thromb Haemost. 2013; 109(4):583-4. DOI: 10.1160/TH12-11-0821. View

12.

Kawakami T, Kobayakawa H, Ohno H, Tanaka N, Ishihara H . Resolution of left atrial appendage thrombus with apixaban. Thromb J. 2013; 11(1):26. PMC: 3878218. DOI: 10.1186/1477-9560-11-26. View

13.

Granger C, Alexander J, McMurray J, Lopes R, Hylek E, Hanna M . Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011; 365(11):981-92. DOI: 10.1056/NEJMoa1107039. View

14.

Patel M, Mahaffey K, Garg J, Pan G, Singer D, Hacke W . Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011; 365(10):883-91. DOI: 10.1056/NEJMoa1009638. View

15.

Varin R, Mirshahi S, Mirshahi P, Klein C, Jamshedov J, Chidiac J . Whole blood clots are more resistant to lysis than plasma clots--greater efficacy of rivaroxaban. Thromb Res. 2013; 131(3):e100-9. DOI: 10.1016/j.thromres.2012.11.029. View