Meeting abstract

https://doi.org/10.15836/ccar2019.245

Inflammation as a procoagulant state for thrombus manifestation in a patient with secondary dilated cardiomyopathy

Andreja Čleković- Kovačić ; Bjelovar General Hospital, Bjelovar, Croatia
Renata Ivanac Janković, ; Bjelovar General Hospital, Bjelovar, Croatia
Ivana Petrović Juren ; Bjelovar General Hospital, Bjelovar, Croatia
Vlasta Soukup Podravec, ; Bjelovar General Hospital, Bjelovar, Croatia
Sandra Prša ; Bjelovar General Hospital, Bjelovar, Croatia
Kristina Milevoj Križić ; Bjelovar General Hospital, Bjelovar, Croatia
Iva Ladić ; Bjelovar General Hospital, Bjelovar, Croatia
Gabrijela Bašković ; Bjelovar General Hospital, Bjelovar, Croatia

Abstract

Introduction: Inflammation is the dynamic process of defense made of chronological changes which
are repercussions of the body on injury or infection, It is made of complex biological and biochemical
reactions which includes crucial cells of the immune system and many lots of biological mediators
stimulated with mechanical injuries, toxins, infections and reaction hypersensitivity. Because of the
disorders of the homeostatic system it is bigger probability of appearing thromboembolic incidence
especially in patients with some disorders. Dilated cardiomyopathy is disease with structural and
functional changes of heart muscle.1-6 In the following case report the 43-year-old male with earlier
known secondary dilated cardiomyopathy who presented with a pneumonia and thrombus in left and
right ventricle.
Case report: 44-year-old male patient with earlier known secondary dilated cardiomyopathy (post myocardial;
from 2014) was hospitalized because of right pneumonia and heart failure. He was presented
with dyspnea and chest pain and with elevated inflammation markers, D-dimer, and NT-proBNP).
Because of chest pain we did the CT pulmonary angiography and we exclude pulmonary embolism.
Echocardiography showed the dilatated (EDD 75 mm) left ventricle (LV) with reduced EF 25-28%. In
akinetic apical part of the LV we noticed the thrombus (7x6 mm) (Figure 1). The right ventricle (RV)
was dilatated (40 mm) with reduced contractility: TAPSE 13 mm, and RVEF around 30%. In the RV
we noticed thrombus (32x22 mm) (Figure 2). With the TEE we confirm the formation of the thrombus
(20x30 mm) in the apical part of the LV. With the antibiotic therapy (piperacillin with tazobactam and
then with azithromycin and tetracycline and with the other medicaments) we achieve regression of
pneumonia and resolution of symptoms of heart failure. In the further processing (in the tertial institution)
with the cardiac magnetic resonance we prove that the formation in the left and the right heart
was thrombus. The patient was prepared for heart transplantation.
Conclusion: Every additional disease can complicate the earlier known heart disease especially with inflammation which has the
procoagulant activity that encourages appearing thrombus. We must be more careful in the patient with some of the heart disease so
that we do not predict it.

Keywords

dilated cardiomyopathy; pneumonia; thrombus; echocardiography.245

Hrčak ID:

226714

URI

https://hrcak.srce.hr/226714

Publication date:

15.10.2019.

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