RESUMEN
RATIONALE: Alcoholic cardiomyopathy (ACM) is associated with various cardiac complications, but the development of isolated right atrial (RA) thrombus without deep vein thrombosis is rare and presents diagnostic challenges. PATIENT CONCERNS: A 53-year-old Hispanic male presented with shortness of breath, chills, cough, bilateral lower extremity edema, and distended abdomen. DIAGNOSES: The patient was diagnosed with ACM, liver cirrhosis, and a large RA thrombus. Initial transthoracic echocardiography showed severe left ventricular systolic dysfunction but failed to detect the RA mass. Subsequent computed tomography scan and transesophageal echocardiography revealed a large oval mass in the RA, measuring 40 mm × 22 mm × 18 mm. INTERVENTIONS: The patient received guideline-directed medical therapy for heart failure and anticoagulation with enoxaparin. He underwent cardiac catheterization for mechanical thrombectomy, which was minimally successful. OUTCOMES: The patient's condition was managed with the prescribed interventions. Regular follow-up was planned to assess thrombolysis. LESSONS: RA thrombosis is an uncommon complication of ACM. A multimodal imaging approach, with a low threshold for transesophageal echocardiography, is crucial in evaluating patients with ACM who present with cardiac complications. This approach enables accurate diagnosis and management of rare conditions like isolated RA thrombosis.
Asunto(s)
Cardiomiopatía Alcohólica , Atrios Cardíacos , Trombosis , Humanos , Masculino , Persona de Mediana Edad , Trombosis/etiología , Trombosis/diagnóstico por imagen , Atrios Cardíacos/diagnóstico por imagen , Cardiomiopatía Alcohólica/complicaciones , Cardiomiopatía Alcohólica/diagnóstico , Ecocardiografía Transesofágica/métodos , Cardiopatías/etiología , Cardiopatías/diagnóstico , Cateterismo Cardíaco/métodos , Trombectomía/métodosRESUMEN
BACKGROUND: Inflammatory bowel diseases, consisting of Crohn's disease and ulcerative colitis, are chronic bowel relapsing inflammatory disorders. Inflammatory bowel diseases begin rarely in infants. Approximately 25% of patients with inflammatory bowel diseases present before the age of 20 years. Very early-onset inflammatory bowel disease occurs before the age of 6 years; infantile inflammatory bowel diseases occurs before the age of 2 years, and is extremely rare in infants under 1 year of age. CASE PRESENTATION: Herein, we report a case series of 7-month-, 11-month-, and 12-month-old Syrian infants that presented with diarrhea, hematochezia, and pale appearance and were finally diagnosed with infantile inflammatory bowel disease and treated. CONCLUSIONS: Early diagnosis and ruling out infantile inflammatory bowel diseases despite its rarity are recommended. Over and above that, new drugs such as vedolizumab, golimumab, and less invasive treatment methods should also be taken into consideration for better response and adequate remission with improved quality of life.