Left ventricular thrombus with normal systolic function secondary to the novel prothrombotic association of acute on chronic calcific pancreatitis and COVID-19


      In the presence of normal left ventricular systolic function, the development of left ventricular thrombus has seldom been documented in hypercoagulable conditions. Echocardiographic results of left ventricular thrombi can be differentiated from those found in cardiac tumors such as myxoma. Many other organs, including the central and peripheral nervous systems, as well as the cardiac and vascular systems, have recently been linked to thromboembolic events in coronavirus disease 2019 (COVID-19). It not only exacerbates acute pancreatitis but often predisposes, in fact, to a novel prothrombotic state in patients with pre-existing comorbid conditions such as chronic calcific pancreatitis. We report an unusual correlation of two prothrombotic disorders – COVID-19 and acute on chronic pancreatitis contributing to the development of thrombus in a normal left ventricle.
      <Learning objective: Intra-cardiac thrombus in a normal functioning left ventricle has not been described in severe SARS-CoV-2 infection. The triple association of COVID-19, acute pancreatitis, and left ventricular thrombus is an extremely rare and fatal disorder. Echocardiography is an easy bedside tool to diagnose intra-cardiac left ventricular thrombus formation in COVID-19 patients with high D-dimer values.>


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        • Jadhav K.P.
        • Jariwala P.
        Intra-cardiac thrombus in COVID-19 pandemic – case series and review.
        Eur J Cardiovasc Med. 2020; VI (Nov 23 Available from:)https://doi.org/10.5083/ejcm20424884.180
        • de-Madaria E.
        • Capurso G.
        COVID-19, and acute pancreatitis: examining the causality.
        Nat Rev Gastroenterol Hepatol. 2021; 18: 3-4
        • Verma A.K.
        • Alam M.
        • Rosman H.S.
        • Brymer J.
        • Keith F.
        Systemic embolization from thrombus in normal left ventricles.
        Chest. 1988; 93: 441-442
        • Vaganos S.A.
        • Fox K.R.
        • Kitchen J.G.
        Left ventricular thrombus in the absence of detectable heart disease.
        Chest. 1989; 96: 426-427
        • Papadopoulos G.
        • Nunez A.
        • Grodman R.
        • Mamadova A.
        • Rahmany Z.
        • El-Eshmawi A.
        • Hao Y.
        • Gala B.
        Massive mobile left ventricular thrombus in a patient with normal left ventricular systolic function.
        CASE. 2019; 3 (Phila): 277-279
        • Al Mazrouei SS
        • GA Saeed
        • Al Helali A.A.
        COVID-19-associated acute pancreatitis: a rare cause of acute abdomen.
        Radiol Case Rep. 2020; 15: 1601-1603
        • Inamdar S.
        • Benias P.C.
        • Liu Y.
        • Sejpal D.V.
        • Satapathy S.K.
        • Trindade A.J.
        • Northwell COVID-19 Research Consortium
        Prevalence, risk factors, and outcomes of hospitalized patients with coronavirus disease 2019 presenting as acute pancreatitis.
        Gastroenterology. 2020; 159 (e2): 2226-2228
        • Cherata D.A.
        • Donoiu I.
        • Mirea O.
        • Diaconu R.
        • Istratoaie O.
        Right atrium floating thrombus and bilateral pulmonary embolism in a patient with pancreatic pseudocyst.
        J Cardiol Cases. 2018; 18: 57-59
        • de Carranza M.
        • Salazar D.E.
        • Troya J.
        • Alcázar R.
        • Peña C.
        • Aragón E.
        • Domínguez M.
        • Torres J.
        • Muñoz-Rivas N.
        Aortic thrombus in patients with severe COVID-19: review of three cases.
        J Thromb Thrombolysis. 2021; 51: 237-242
        • Frantzeskaki F.
        • Armaganidis A.
        • Orfanos S.E.
        Immunothrombosis in acute respiratory distress syndrome: cross talks between inflammation and coagulation.
        Respiration. 2017; 93: 212-225