Tomislav Miljak1, Markus Kunze, Ralf Birkemeyer, Werner Jung. 1. Klinik für Innere Medizin III (Kardiologie), Schwarzwald-Baar Klinikum Villingen-Schwenningen GmbH, Villingen-Schwenningen, Germany. Tomislav.Miljak@sbk-vs.de
Abstract
CASE REPORT: A 69-year-old woman was admitted to hospital for cardioversion of persistent atrial fibrillation. She was on anticoagulation with a vitamin K antagonist for several weeks. Transesophageal echocardiography revealed a left atrial appendage aneurysm with a floating thrombus. None of the risk factors for thromboembolism mentioned in the guidelines for the management of patients with atrial fibrillation were present. As the patient refused surgical resection, long-term anticoagulation was recommended. CONCLUSION: Due to their scarcity, patients with left atrial appendage aneurysms are not considered in current management guidelines. Since this anomaly is associated with a potential risk of systemic embolization, surgical resection should be recommended even in asymptomatic patients.
CASE REPORT: A 69-year-old woman was admitted to hospital for cardioversion of persistent atrial fibrillation. She was on anticoagulation with a vitamin K antagonist for several weeks. Transesophageal echocardiography revealed a left atrial appendage aneurysm with a floating thrombus. None of the risk factors for thromboembolism mentioned in the guidelines for the management of patients with atrial fibrillation were present. As the patient refused surgical resection, long-term anticoagulation was recommended. CONCLUSION: Due to their scarcity, patients with left atrial appendage aneurysms are not considered in current management guidelines. Since this anomaly is associated with a potential risk of systemic embolization, surgical resection should be recommended even in asymptomatic patients.
Authors: Prema Ramaswamy; Irene D Lytrivi; Shubhika Srivastava; Sangeeta Sharma; H Helen Ko; Ira A Parness; Wyman W Lai Journal: J Am Soc Echocardiogr Date: 2007-06-25 Impact factor: 5.251
Authors: Valentin Fuster; Lars E Rydén; David S Cannom; Harry J Crijns; Anne B Curtis; Kenneth A Ellenbogen; Jonathan L Halperin; Jean-Yves Le Heuzey; G Neal Kay; James E Lowe; S Bertil Olsson; Eric N Prystowsky; Juan Luis Tamargo; Samuel Wann; Sidney C Smith; Alice K Jacobs; Cynthia D Adams; Jeffery L Anderson; Elliott M Antman; Sharon Ann Hunt; Rick Nishimura; Joseph P Ornato; Richard L Page; Barbara Riegel; Silvia G Priori; Jean-Jacques Blanc; Andrzej Budaj; A John Camm; Veronica Dean; Jaap W Deckers; Catherine Despres; Kenneth Dickstein; John Lekakis; Keith McGregor; Marco Metra; Joao Morais; Ady Osterspey; José Luis Zamorano Journal: J Am Coll Cardiol Date: 2006-08-15 Impact factor: 24.094