Abstract
The case of a 78-year-old female patient who suffered atrial fibrillation and persistent thrombus in the left atrial appendage despite sufficient anticoagulation is reported. The case is chosen to demonstrate the complexity inherent in prophylaxis as well as risk evaluation of thromboembolism on the basis of clinical and echocardiographic criteria. We also discuss transesophageal echocardiography as the standard diagnostic procedure for detection of intracardiac thrombi prior to cardioversion as well as cardiac computer tomography as an alternative.
Publication types
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Case Reports
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English Abstract
MeSH terms
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Administration, Oral
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Adrenergic beta-Antagonists / administration & dosage
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Aged
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Anticoagulants / administration & dosage*
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Atrial Fibrillation / blood
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Atrial Fibrillation / complications*
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Atrial Fibrillation / drug therapy*
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Drug Therapy, Combination
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Echocardiography
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Echocardiography, Transesophageal
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Electric Countershock
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Enoxaparin / administration & dosage
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Female
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Heart Atria*
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Heart Diseases / blood
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Heart Diseases / diagnosis*
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Heart Diseases / etiology
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Heart Diseases / therapy
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Humans
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International Normalized Ratio
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Phenprocoumon / administration & dosage*
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Risk Factors
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Thromboembolism / etiology
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Thrombosis / blood
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Thrombosis / diagnosis*
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Thrombosis / etiology
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Thrombosis / therapy
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Tomography, X-Ray Computed
Substances
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Adrenergic beta-Antagonists
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Anticoagulants
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Enoxaparin
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Phenprocoumon