Abstract:
Introduction. Intracardiac thrombi are a complication associated with cardiomyopathies.
Studies indicate that intraventricular thrombi are a significant complication of heart failure
with reduced ejection fraction and can range from 2.1% to 7.0% in patients with severe
systolic dysfunction.
Objective(s). Presentation of the clinical case of a young patient who developed dilated
cardiomyopathy of post-inflammatory etiology with heart failure and reduced ejection
fraction.
Materials and methods. Patient B., 39 years old, admitted to the Cardiology Department of
MSPI "Holy Trinity" with the following complaints: marked asthenia, dyspnea on light
physical exertion, cardiac palpitations, retrosternal pain. From the anamnesis, the patient
does not suffer from heart disease, a month ago he underwent ARVI with outpatient
treatment. Investigations performed: electrocardiogram, echocardiography, chest
radiography, hemoleukogram, biochemical analyses.
Results. On admission: t 36.7°C, FCC 135 b/min, BP 100/60 mmHg, SpO2 - 98%, FR -
21/min. ECG: Sinusal rhythm with FCC 125 b/min, without signs of acute ischemia.
Laboratory results: general analysis, biochemical blood test, coagulogram without changes,
negative cardiac markers, elevated NTproBNP. Chest radiography: hydrothorax on the left.
Ultrasound of internal organs: bilateral hydrothorax, ascites. EchoCG: tetracameral dilation,
diffuse reduced EF 20%, PSAP 51 mmHg, restrictive diastolic dysfunction, apical thrombi in
the LV and RV cavities partially fixed with elements. After 14 days, the general condition
improved. On radiography, bilateral pleural resorption. ECHO: complete resorption of
thrombi in the LV and RV, EF 26%, decreased NTproBNP (1034 to 844 pg/ml).
Conclusion(s). Reduced ejection fraction is an established risk factor for the development
of intracavitary thrombi in 20-25% of patients, which makes anticoagulant therapy even
more crucial in preventing thromboembolic complications.
