Intra-atrial thrombus in a neonate with coarctation of the aorta

Atrial Thrombus in a Neonate: A Diagnostic Challenge

Introduction Left atrial thrombus is a rare finding in a neonate. In the previous literature, atrial thrombi have been associated with catheter placement or congenital heart disease in a preterm infant. Case We report the case of a full-term neonate with no known risk factors found to have a left atrial thrombus. The neonate was born at 38 weeks' gestation to a 31-year-old female via cesarean section who was sent to the normal nursery. On postnatal day 5, the infant was noted to have low-to-medium level of oxygen saturations (∼90%) and was transferred to the neonatal intensive care unit with an echocardiogram completed on postnatal day 6 demonstrating a mobile, pedunculated mass attached to the left atrial septum with an appearance concerning for atrial myxoma. The infant underwent surgical resection on postnatal day 8 and pathology revealed the mass to be a left atrial thrombus. Discussion The rare finding of an atrial thrombus in a neonate has previously been associated with central venous catheter placement or congenital heart disease. This case is unusual in that the patient had neither condition. Although echocardiogram findings appeared more consistent with atrial myxoma, final pathology revealed a left atrial thrombus. Additionally, hypercoagulability work-up for this neonate was largely negative. This report underscores the importance of identification, search for etiology, and prompt therapy to prevent potential catastrophic outcomes.

Thrombus in the left atrial appendage: a case report of neonate

A Japanese girl first pointed out the mass in the left atrial appendage by the echocardiography on the 3rd day of life. At 30th day of life, the mass in the left atrial appendage was excised en bloc successfully under cardiopulmonary bypass because it appeared mobile. Its pathologic finding revealed an old organised thrombus. She is doing well with no episode of thrombus formation or thromboembolism, 2 years postoperatively.

Unusual intraatrial thrombus in a neonate with coarctation of the aorta

Left atrial thrombus in neonates is uncommon. We describe a newborn with coarctation of the aorta, in whom a thrombus confined to the left appendage was discovered on the first day of life and was thought to be a myxoma.

Left atrium thrombus in an extremely low-birthweight infant with late-onset circulatory dysfunction

A left atrium thrombus, potentially a life-threatening complication, is an extremely rare in early infancy. Most cases are caused by mal-placement of central venous catheters or related to congenital heart diseases with left atrial blood congestion. Here we present an extremely low birth weight infant who developed a left atrial thrombus during the course of late onset circulatory dysfunction. The thrombus was successfully treated by recombinant tissue plasminogen activator. A hemodynamically unstable condition like late onset circulatory dysfunction should be taken into consideration as a potential risk condition of this rare disease.

Staphylococcus aureus Septicemia with a fatal transmural myocardial infarction in a 27-week-gestation twin infant: a case study

Septicemia, one of the major causes of morbidity and mortality in the neonatal period, often has a rapid and fulminant course. Low-birth-weight infants with persistent Staphylococcus aureus septicemia, possibly associated with percutaneous central venous catheters, may develop metastatic infections including endocarditis with large vegetations. This article describes a neonate with S. aureus bacteremia that resolved with treatment who died secondary to decreased left ventricular function. At autopsy, organizing microthrombi were seen within both atria, the left ventricle, and the left coronary arterial system. Extensive infarcts were noted throughout the entire myocardium of the left ventricle. It was suspected, but not proven, that the thrombotic sequelae from septicemia caused this neonate's death.

An unusual right atrial mass in a two-month old infant

We report a 2-month old female with a rare cardiac mass. She was evaluated echocardiographically after physical examination revealed a low grade cardiac murmur. The mass, located in right atrium, was shown to be the consequence of candida endocarditis by means of pathological study and blood culture.