Simultaneous Left Ventricular and Deep Vein Thrombi Caused by Protein C Deficiency
Protein C deficiency is a risk of venous thrombosis because of poor fibrinolytic activity. It remains controversial whether protein C deficiency causes arterial thrombosis. A 21-year-old woman was referred with a chief complaint of right leg pain and numbness. Contrast-enhanced computed tomography r...
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Wiley
2017-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2017/4240959 |
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| author | Harufumi Maki Motohiro Nishiyama Motoaki Shirakawa |
| author_facet | Harufumi Maki Motohiro Nishiyama Motoaki Shirakawa |
| author_sort | Harufumi Maki |
| collection | DOAJ |
| description | Protein C deficiency is a risk of venous thrombosis because of poor fibrinolytic activity. It remains controversial whether protein C deficiency causes arterial thrombosis. A 21-year-old woman was referred with a chief complaint of right leg pain and numbness. Contrast-enhanced computed tomography revealed a low-density mass in the left ventricle (LV), splenic infarction, and peripheral arterial obstructions in her right leg. Thrombosis extending from the renal vein to the inferior vena cava was also detected. Electrocardiography revealed ST depression in leads II, III, and aVF. Transthoracic echocardiography revealed hypokinesis of the apex and interventricular septum and a hypoechoic mass in the LV (26 × 20 mm). She was diagnosed with acute arterial obstruction caused by the LV thrombus, which might have resulted from previous myocardial infarction. Protein C activation turned out to be low (41%) 5 days after admission. The anticoagulant therapy was switched from heparin to rivaroxaban 16 days after admission. The LV thrombus disappeared 24 days after initial treatment, and she has had no thrombotic episodes for 2.8 years under rivaroxaban therapy. Thrombophilia should be investigated for cases of simultaneous left ventricular and deep venous thrombi. Rivaroxaban can be effective in prevention of further thrombotic events. |
| format | Article |
| id | doaj-art-b770380c0d4c41adbb6322834754e7e6 |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
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| series | Case Reports in Medicine |
| spelling | doaj-art-b770380c0d4c41adbb6322834754e7e62025-02-03T01:20:26ZengWileyCase Reports in Medicine1687-96271687-96352017-01-01201710.1155/2017/42409594240959Simultaneous Left Ventricular and Deep Vein Thrombi Caused by Protein C DeficiencyHarufumi Maki0Motohiro Nishiyama1Motoaki Shirakawa2Department of Surgery, Fujieda Municipal General Hospital, 4-1-11 Surugadai, Fujieda, Shizuoka 426-8677, JapanDepartment of Surgery, Fujieda Municipal General Hospital, 4-1-11 Surugadai, Fujieda, Shizuoka 426-8677, JapanDepartment of Surgery, Fujieda Municipal General Hospital, 4-1-11 Surugadai, Fujieda, Shizuoka 426-8677, JapanProtein C deficiency is a risk of venous thrombosis because of poor fibrinolytic activity. It remains controversial whether protein C deficiency causes arterial thrombosis. A 21-year-old woman was referred with a chief complaint of right leg pain and numbness. Contrast-enhanced computed tomography revealed a low-density mass in the left ventricle (LV), splenic infarction, and peripheral arterial obstructions in her right leg. Thrombosis extending from the renal vein to the inferior vena cava was also detected. Electrocardiography revealed ST depression in leads II, III, and aVF. Transthoracic echocardiography revealed hypokinesis of the apex and interventricular septum and a hypoechoic mass in the LV (26 × 20 mm). She was diagnosed with acute arterial obstruction caused by the LV thrombus, which might have resulted from previous myocardial infarction. Protein C activation turned out to be low (41%) 5 days after admission. The anticoagulant therapy was switched from heparin to rivaroxaban 16 days after admission. The LV thrombus disappeared 24 days after initial treatment, and she has had no thrombotic episodes for 2.8 years under rivaroxaban therapy. Thrombophilia should be investigated for cases of simultaneous left ventricular and deep venous thrombi. Rivaroxaban can be effective in prevention of further thrombotic events.http://dx.doi.org/10.1155/2017/4240959 |
| spellingShingle | Harufumi Maki Motohiro Nishiyama Motoaki Shirakawa Simultaneous Left Ventricular and Deep Vein Thrombi Caused by Protein C Deficiency Case Reports in Medicine |
| title | Simultaneous Left Ventricular and Deep Vein Thrombi Caused by Protein C Deficiency |
| title_full | Simultaneous Left Ventricular and Deep Vein Thrombi Caused by Protein C Deficiency |
| title_fullStr | Simultaneous Left Ventricular and Deep Vein Thrombi Caused by Protein C Deficiency |
| title_full_unstemmed | Simultaneous Left Ventricular and Deep Vein Thrombi Caused by Protein C Deficiency |
| title_short | Simultaneous Left Ventricular and Deep Vein Thrombi Caused by Protein C Deficiency |
| title_sort | simultaneous left ventricular and deep vein thrombi caused by protein c deficiency |
| url | http://dx.doi.org/10.1155/2017/4240959 |
| work_keys_str_mv | AT harufumimaki simultaneousleftventricularanddeepveinthrombicausedbyproteincdeficiency AT motohironishiyama simultaneousleftventricularanddeepveinthrombicausedbyproteincdeficiency AT motoakishirakawa simultaneousleftventricularanddeepveinthrombicausedbyproteincdeficiency |