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Postgrad Med J doi:10.1136/postgradmedj-2013-131933
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Quadri-chamber cardiac thrombi in alcoholic cardiomyopathy: a rare though ominous finding

  1. Cholenahally Nanjappa Manjunath
  1. Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India
  1. Correspondence to Dr Yadvinder Singh, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka 560069, India; dryadvinder{at}hotmail.com
  • Received 7 March 2013
  • Revised 24 April 2013
  • Accepted 30 April 2013
  • Published Online First 24 May 2013

Introduction

Alcoholic cardiomyopathy is a cause of reversible cardiomyopathy, in which long-term abuse of alcohol leads to ventricular dysfunction. Multiple mechanisms have been attributed to the development of alcoholic cardiomyopathy such as mitochondrial damage and oxidative stress, though coexistent nutritional deficiencies like thiamine deficiency, tobacco abuse and other comorbidities such as hypertension can contribute to ventricular dysfunction. Ventricular thrombus formation can occur secondary to akinesia or hypokinesia of the ventricular wall. We report a case of alcoholic cardiomyopathy with an alarming finding of thrombi in all cardiac chambers. Echocardiographic evidence of quadri-chamber intracardiac thrombi has rarely been described in the literature.

Case

A 48-year-old man with history of chronic alcoholism presented with progressive breathlessness of 1 year's duration. Cardiovascular examination showed sinus tachycardia and evidence of congestive …


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