American Journal of Case Reports最新文献

{"title":"Efficacy of Pola-R-CHP and Autologous Stem Cell Transplantation in Untreated Burkitt Lymphoma: A Case Report.","authors":"Yang Yang, Yuhong Ren, Jing Li, Peng Liu","doi":"10.12659/AJCR.948969","DOIUrl":"10.12659/AJCR.948969","url":null,"abstract":"<p><p>BACKGROUND Burkitt lymphoma is an aggressive B-cell lymphoma curable with highly dose-intensive chemotherapy derived from pediatric leukemia regimens. However, the adverse event profile, including myelosuppression, infection, and multi-organ dysfunction, worsens with increasing age. This report describes the first case of an 56-year-old woman diagnosed with Burkitt lymphoma who was treated with upfront polatuzumab vedotin plus rituximab, cyclophosphamide, doxorubicin, and prednisone (Pola-R-CHP) followed by autologous stem cell transplantation consolidation. CASE REPORT An 56-year-old Asian female patient with reduced body weight and severe malnutrition and unfit for standard therapies had an aggravating onset of abdominal pain and constipation. Diagnosis of high-risk Burkitt lymphoma was made by pathological biopsy, with intermediate-sized mature malignant B cells that expressed CD10, bcl-6 but not bcl-2, with high Ki-67 index (90%) and c-MYC translocation. She was treated with Pola-R-CHP. After the first dose of therapy, her abdominal pain was rapidly relieved. A grade 3 pneumonia after the fourth cycle was treated with antibiotics and best supportive care. After 6 cycles of induction therapy, complete metabolic remission was confirmed by positron emission tomography/computed tomography (PET/CT). To consolidate the response, she underwent autologous stem cell transplantation, and afterward, complete metabolic remission status was maintained. The last CT scan showed a continuous response of 12.9 months after the initiation of chemoimmunotherapy. Follow-up was still ongoing through blood tests and CT examination every 3 months. CONCLUSIONS Upfront Pola-R-CHP had a quick and durable response and was well-tolerated in untreated Burkitt lymphoma. Further research is required to confirm the conclusions.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948969"},"PeriodicalIF":0.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postictal Petechial Skin Rash (Trout Skin) After a First Epileptic Seizure in a 54-Year-Old Man.","authors":"Annina Bopp, Sarah Albrecht, Lars C Huber","doi":"10.12659/AJCR.948740","DOIUrl":"10.12659/AJCR.948740","url":null,"abstract":"<p><p>BACKGROUND Postictal petechiae have a recognized but rare association with epileptic seizures, possibly due to increased capillary pressure and blood leakage. The appearance has been likened to that of trout skin, and the pinpoint skin petechiae retain their color even when pressure is applied. This report describes the case of a 54-year-old man with a postictal petechial skin rash (trout skin) following a first epileptic seizure. CASE REPORT A 54-year-old man arrived at our hospital's emergency room after experiencing a loss of consciousness for the first time. Except for slight disorientation, no focal neurological deficits were found. The only notable clinical abnormality was a petechial rash confined to the face, neck, and chest. Laboratory analysis showed no signs of inflammation or coagulation disorder. Further testing, including computed tomography (CT), magnetic resonance imaging (MRI), and electroencephalography (EEG), revealed no abnormalities. Based on the patient's history, postictal state, tongue biting, and the characteristic petechial rash, we diagnosed a first-time epileptic seizure. Antiepileptic therapy with levetiracetam was initiated. CONCLUSIONS This report highlights the known but rare association of postictal petechiae (trout skin) with epileptic seizures, which is a clinical sign that may assist the clinician in identifying a cause of loss of consciousness when the clinical history is unclear.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948740"},"PeriodicalIF":0.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acupotomy to Treat Inversion of the Second Toe Combined with Eversion of the First Metatarsophalangeal Toe: A Case Report.","authors":"Zehao Hu, Hao Qin, Qiuxuan Huang, Zhanxin Li","doi":"10.12659/AJCR.949599","DOIUrl":"10.12659/AJCR.949599","url":null,"abstract":"<p><p>BACKGROUND Hallux valgus (HV), characterized by lateral deviation of the first metatarsophalangeal joint (MJ) and medial metatarsal protrusion, frequently causes pain and gait dysfunction. Conventional treatments face limitations in efficacy or invasiveness. Acupotomy is a minimally invasive microsurgery technique that uses a needle knife and microtrauma to detach tissue associated with contractures. It may be used with or without ultrasound guidance. This report describes the case of a 52-year-old woman with varus deformity of the second toe and valgus deformity of the left first metatarsophalangeal joint that was managed with minimally invasive acupotomy. CASE REPORT A 52-year-old woman presented with a 5-year history of left foot pain, second toe varus, and first metatarsophalangeal valgus, worsening with activity despite conservative management. Symptoms included callus formation and limited joint mobility. Diagnosed with both deformities, she underwent 6 acupotomy sessions targeting the medial first MJ capsule, adductor/abductor pollicis tendon insertions, second toe flexor sheath, medial second MJ capsule, and intermetatarsal ligament, followed by dynamic traction and muscle training. Immediate post-treatment results showed second toe varus angle (TVA) reduction ≥15°, passive extension improvement >10°, and hallux valgus angle (HVA) decrease ≥5°. At 2-month follow-up, TVA further improved ≥18°, passive extension increased >13°, HVA stabilized ≥5° reduction, and pain as measured on the visual analogue scale decreased to 3 points. CONCLUSIONS Acupotomy effectively restored foot biomechanics by releasing soft tissue contractures and redistributing plantar stress, achieving mechanical correction and functional recovery. This minimally invasive approach demonstrates promise for mild-to-moderate HV with secondary deformities, particularly for which surgery is contraindicated. Further studies are warranted to standardize protocols and validate long-term efficacy.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e949599"},"PeriodicalIF":0.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dermoid Cyst Causing Neonatal Brain Abscesses: A Case Report.","authors":"Yi Yuan, Ping Zhou, Xiaojun Dong, Yong Sun, Zongjian An","doi":"10.12659/AJCR.948196","DOIUrl":"10.12659/AJCR.948196","url":null,"abstract":"<p><p>BACKGROUND Brain abscess is a rare yet severe complication of neonatal meningitis, occurring in approximately 10% of neonates with this infection. This report details a case of neonatal brain abscess originating from a dermoid cyst. Although dermoid cysts are benign, they can rupture or become infected, leading to central nervous system (CNS) complications such as brain abscesses. Clinical manifestations can be subtle, often presenting as non-specific symptoms like headache, fever, and irritability, which can progress to severe neurological dysfunction or seizures. Early identification and intervention, including surgical and antimicrobial therapies, are crucial for improving outcomes. CASE REPORT We report a case of a neonatal dermoid cyst located at the cranial vertex, communicating with the intracranial cavity, and clinically presenting as a brain abscess. The patient had a favorable outcome following surgical intervention and anti-infective therapy. This case underscores the importance of considering rare etiologies in neonatal brain abscesses and emphasizes the need for prompt diagnosis and treatment to optimize patient outcomes. A detailed discussion of the diagnostic and therapeutic strategies employed in this case shows their potential influence on clinical decision-making in similar situations. CONCLUSIONS This case highlights the critical importance of precise diagnosis and timely intervention in optimizing patient outcomes. It also serves as a reminder for clinicians to carefully differentiate complications of purulent meningitis from other mimicking conditions, ensuring the implementation of appropriate treatment strategies to prevent severe complications. The insights gained from this case may inform the management of similar presentations, underscoring the necessity for a high index of suspicion and early intervention in neonatal brain abscesses.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948196"},"PeriodicalIF":0.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial Manic Presentation in Creutzfeldt-Jakob Disease: A Case Report.","authors":"Fatima Ghazi Alotaibi, Rakan Bahammam, Khalid M Alqarni, Othman O Aldraihem","doi":"10.12659/AJCR.949905","DOIUrl":"10.12659/AJCR.949905","url":null,"abstract":"<p><p>BACKGROUND Creutzfeldt-Jakob disease (CJD) is a rare and fatal neurodegenerative condition caused by misfolded prion proteins. It most commonly presents with rapidly progressive dementia and neurological deterioration. While psychiatric symptoms are not unusual in the early stages of CJD, it is very uncommon for the disease to begin with manic features as the primary presentation. CASE REPORT We describe the case of a 65-year-old woman who initially developed symptoms consistent with mania. These included an elevated mood, emotional instability, and insomnia. Over time, her clinical condition worsened, and she began to experience hallucinations, along with a noticeable motor decline. Due to the atypical nature of her initial symptoms, she was first treated for viral encephalitis, which contributed to a delay in establishing the correct diagnosis. Subsequent investigations played a key role in clarifying the underlying pathology. Brain magnetic resonance imaging (MRI) revealed characteristic findings of CJD, including cortical ribboning and changes in the basal ganglia. Electroencephalography (EEG) showed periodic sharp-wave complexes, further supporting the diagnosis. Cerebrospinal fluid analysis tested positive for prion protein using real-time quaking-induced conversion (RT-QuIC), confirming a final diagnosis of sporadic CJD (sCJD). CONCLUSIONS Although rare, mania can be an early sign of CJD. This case illustrates the diagnostic challenges that arise when psychiatric symptoms dominate the initial clinical picture. It emphasizes the importance of maintaining a broad differential diagnosis when evaluating new-onset psychiatric symptoms in older adults, especially when these symptoms are accompanied by a rapid decline in cognition or motor function. Early consideration of CJD in such scenarios may help expedite diagnosis, avoid unnecessary treatments, and provide clarity for patients and families facing a progressive and life-limiting illness.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e949905"},"PeriodicalIF":0.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cannabis-Induced Cardiac Arrest in a Young Adult: A Case Report.","authors":"Sana Irshad, Parth Adrejiya, Mohammad Abubaker, Theophilus Adatsi, Oluchi Idenyi, Srikanth Maddika, Swathi Gorle, Abhishek Thandra, Srinivasa R Chennareddy","doi":"10.12659/AJCR.950077","DOIUrl":"10.12659/AJCR.950077","url":null,"abstract":"<p><p>BACKGROUND Tetrahydrocannabinol (THC), the psychoactive compound in cannabis, is increasingly used recreationally, especially among young adults. Although often perceived as harmless, emerging evidence links THC to serious cardiovascular complications, including QTc prolongation, ventricular arrhythmias, and sudden cardiac arrest, even in individuals without underlying heart disease. CASE REPORT A 26-year-old woman with a history of chronic cannabis use was brought to the Emergency Department (ED) after having a sudden cardiac arrest. Her initial rhythm was ventricular fibrillation, and return of spontaneous circulation was achieved following advanced cardiac life support. An initial electrocardiogram revealed sinus tachycardia with a QTc interval of 483 ms, and a urine drug screen was positive for THC. Cardiac catheterization performed 4 weeks later revealed normal coronary arteries. Her left ventricular ejection fraction, initially reduced at 25-30%, had normalized by the time of catheterization. She sustained hypoxic-ischemic brain injury, requiring prolonged rehabilitation. CONCLUSIONS This case highlights the potential for cannabis use to induce life-threatening cardiac arrhythmias, including QTc prolongation, and ventricular fibrillation, even in young adults with no prior cardiovascular risk factors. Clinicians should maintain a high index of suspicion for cannabis-induced cardiotoxicity in similar presentations, particularly as cannabis use becomes more widespread.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e950077"},"PeriodicalIF":0.7,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Gluteal Compartment Syndrome and Sciatic Nerve Palsy Following Prolonged Immobilization in an Intravenous Drug User: A Case Report.","authors":"Platon Papageorgiou, Vasileios Giannatos, Panagiotis Antzoulas, Evangelia Argyropoulou, Christos Koukos, Zinon Kokkalis","doi":"10.12659/AJCR.948893","DOIUrl":"10.12659/AJCR.948893","url":null,"abstract":"<p><p>BACKGROUND Compartment syndrome is a serious condition characterized by increased interstitial pressure within a closed osseofascial compartment, which can result from decreased compartment volume, increased contents, or external pressures. Gluteal and thigh compartment syndrome, although rare, is linked to severe local complications such as tissue necrosis, infection, and even amputation, as well as systemic issues like renal failure and, in some cases, death. Prompt recognition and treatment are essential for improving outcomes, as delays significantly raise the risk of adverse and potentially life-threatening consequences. Acute gluteal compartment syndrome often results from prolonged pressure due to immobilization and can be associated with collapse caused by alcohol or drug abuse. CASE REPORT A 30-year-old male intravenous drug user (IVDU) was admitted with severe pain, swelling, and motor deficits in the right thigh and gluteal region due to prolonged immobilization during loss of consciousness from drug use. Examination revealed sciatic nerve palsy. Magnetic resonance imaging (MRI) showed swelling of the gluteal and posterior thigh muscles along with fluid collection. Emergency fasciotomy and sciatic nerve release were performed through a posterior approach. Postoperatively, the patient experienced rapid improvement in neurological function and mobility. CONCLUSIONS Our findings underscore the importance of maintaining a high index of suspicion among immobilized patients, especially intravenous drug users who may remain unconscious for extended periods, crushing parts of their bodies. Early recognition and intervention are vital for preventing severe complications associated with this condition. This case highlights the need for increased awareness and proactive management when treating IVDUs presenting with severe pain in the gluteal or thigh region and acute sciatic nerve palsy.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948893"},"PeriodicalIF":0.7,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Liver Transplant Complications: EBV-Associated Tumors and Infection Management Strategies.","authors":"Li-Na Wu, Zhi-Gui Zeng, Jing-Yi Liu, Lin Wei, Yu-Le Tan, Fu-Xiao Xie, Zhi-Jun Zhu, Li-Ying Sun","doi":"10.12659/AJCR.948566","DOIUrl":"10.12659/AJCR.948566","url":null,"abstract":"<p><p>BACKGROUND EBV-associated smooth muscle tumors (EBV-SMTs) are rare malignancies in pediatric transplant recipients under chronic immunosuppression, with fewer than100 cases reported globally. Diagnosis is challenging due to nonspecific imaging findings and overlapping features with other post-transplant malignancies, necessitating histopathological confirmation. This underscores the need for heightened clinical suspicion in high-risk cohorts. CASE REPORT Here, we present a pediatric case from our liver transplant (LT) center involving a patient who developed both post-transplant lymphoproliferative disorder (PTLD) and EBV-SMT following liver transplantation. Clinical data and comprehensive treatment details of this rare case were retrospectively reviewed. The patient, diagnosed with a congenital bile acid synthesis defect, underwent liver transplantation at the age of 5 months. Pre-transplant screening confirmed that both the donor and recipient were negative for cytomegalovirus (CMV) and Epstein-Barr virus (EBV) infections. However, EBV DNA became detectable in peripheral blood at 22.5 months after transplantation and showed a progressive increase over time. At 30.9 months after LT, PTLD and hepatic EBV-SMT were simultaneously diagnosed through histopathological examination. Treatment strategies included stepwise immunosuppression reduction, administration of rituximab targeting PTLD, and subsequent sirolimus therapy for EBV-SMT and surgical resection of the liver and splenic tumor. This multidisciplinary approach successfully achieved complete remission. CONCLUSIONS EBV-SMT necessitates multidisciplinary management balancing immunosuppression with targeted therapies. mTOR inhibitors are a strategic option for concurrent rejection prevention and tumor control. Sirolimus, a mechanistic target of rapamycin (mTOR) inhibitor, demonstrates promise by simultaneously preventing rejection and inhibiting tumor progression.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948566"},"PeriodicalIF":0.7,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alveolar Echinococcosis Mimicking Perihilar Cholangiocarcinoma Leading to Liver Transplant: A Case Report.","authors":"Hrvoje Premec, Mislav Barišić-Jaman, Petra Dinjar Kujundžić, Nikola Sobočan, Maja Mijić, Miloš Lalovac, Frane Paštrović, Vid Matišić, Ivica Grgurević, Tajana Filipec-Kanižaj","doi":"10.12659/AJCR.948414","DOIUrl":"10.12659/AJCR.948414","url":null,"abstract":"<p><p>BACKGROUND Alveolar echinococcosis (AE) is a slowly progressive parasitic disease that primarily affects the liver and resembles primary or secondary liver neoplasms. Differentiating AE from other primary or secondary liver malignancies is of paramount importance, due to differing therapeutic approaches. The disease is uncommon in developed countries. Initial extrahepatic manifestation mimicking a primary biliary neoplasm is extremely rare. A broad differential diagnosis and low disease prevalence make the diagnosis of primary biliary AE extremely challenging. CASE REPORT We present a 32-year-old male patient with perihilar AE and no significant past medical history. The initial clinical presentation and radiological findings were compatible with the diagnosis of perihilar cholangiocarcinoma (Klatskin tumor). The patient subsequently underwent extensive invasive diagnostic procedures, including endoscopic ultrasound and endoscopic retrograde cholangiopancreatography, which led to choledochal perforation and biliary leakage, necessitating urgent surgical procedure, along with exploration, evacuation of enlarged lymph nodes, and subsequent histopathological examination. None of the procedures provided definitive evidence of malignancy. Only an ultrasound-guided percutaneous biopsy followed by histopathological examination revealed AE. Albendazole treatment and close follow-up were initiated. Subsequently, the patient experienced recurrent episodes of acute cholangitis. Recurrent cholangitis and perihilar biliary involvement, precluding radical surgical resection, necessitated liver transplantation. Ultimately, the patient underwent orthotopic liver transplantation from a brain-dead donor, with a favorable outcome. CONCLUSIONS Liver transplantation is a definitive treatment option for selected patients with perihilar liver involvement precluding radical resection of parasitic mass and recurrent episodes of acute cholangitis.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948414"},"PeriodicalIF":0.7,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Left Ventricular Thrombus in the Context of Heart Failure and COVID-19: A Case Report.","authors":"Jochebet Irene, Teuku Muhammad Haykal Putra, Wahyu Aditya Soedarsono, Wishnu Aditya Widodo, Raja Ezman Raja Shariff","doi":"10.12659/AJCR.949609","DOIUrl":"10.12659/AJCR.949609","url":null,"abstract":"<p><p>BACKGROUND Left ventricular thrombus (LVT) is a common complication of heart failure and acute myocardial infarction. A peak mortality rate of 27.9% for LVT has been reported, especially among patients with severe LV systolic dysfunction. Poor hemodynamics and blood stasis contribute to the development of LVT by disrupting normal blood flow, which promotes thrombus formation. Conversely, LVT significantly impairs cardiac function, resulting in reduced stroke volume, decreased cardiac output, and an increased risk of systemic embolism, stroke, cardiovascular events, and mortality. CASE REPORT We report a case of a 59-year-old woman presenting with severe dyspnea. Acute decompensated heart failure was diagnosed. A massive LVT occupying over half of the left ventricle was identified on transthoracic echocardiography. The estimated volume of the thrombus was 140 mL, calculated using the end-diastolic volume formula from echocardiography. Presumably, the condition was precipitated by a previous infection of COVID-19. An aggressive diuretic strategy relieved her congestive symptoms. However, intravenous anticoagulation, overlapped with oral anticoagulant, did not alter the thrombus. The patient's condition deteriorated significantly, resulting in multiple episodes of rehospitalizations and eventual death due to low cardiac output syndrome in her last 3 months of follow-up. CONCLUSIONS This case underscores the impact of large thrombi on LV performance and hemodynamics exacerbating heart failure symptoms, and finally leading to severe complications and mortality. The patient's SARS-CoV-2 infection likely contributed to the hypercoagulable state and thrombus formation.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e949609"},"PeriodicalIF":0.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}