{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T03:16:02Z","timestamp":1789096562179,"version":"build-2803163510"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,2,13]],"date-time":"2023-02-13T00:00:00Z","timestamp":1676246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Increased intracardiac thrombus formation in light-chain cardiac amyloidosis (AL-CA) has been associated with thrombotic events such as stroke and high rates of mortality and morbidity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 51-year-old man was admitted to the emergency department with a sudden change in consciousness. His emergency brain magnetic resonance imaging showed two foci of cerebral infarction on the bilateral temporal lobes. His electrocardiogram displayed a normal sinus rhythm with low QRS voltage. Transthoracic echocardiography showed concentric thickened ventricles, dilatation of both atria, a left ventricular ejection fraction of 53%, and a Grade 3 diastolic dysfunction. The bull-eye plot on speckle tracking echocardiography displayed a distinctive apical sparing pattern. A serum-free immunoglobulin analysis showed increased lambda-free light chains (295.59\u2005mg\/L) with a reduced kappa\/lambda ratio (0.08). Light-chain amyloidosis was subsequently confirmed by examining the histology of the abdominal fat-pad tissue. On transoesophageal echocardiography (TEE), an elongated static thrombus and a mobile bouncing oval thrombus were found on the left and right atrial appendages, respectively. Atrial thrombi were managed with a full dose of dabigatran of 150\u2005mg twice daily, which resulted in a complete resolution after 2 months of TEE follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Complicating intracardiac thrombosis has been considered one of the major contributions of death in cardiac amyloidosis. Transoesophageal echocardiography should be established to aid in the detection and management of atrial thrombus in AL-CA.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytad076","type":"journal-article","created":{"date-parts":[[2023,2,13]],"date-time":"2023-02-13T16:52:08Z","timestamp":1676307128000},"source":"Crossref","is-referenced-by-count":3,"title":["Use of transoesophageal echocardiography to detect and manage atrial thrombi in light-chain cardiac amyloidosis: a case report"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3494-2958","authenticated-orcid":false,"given":"Toan Quang","family":"Dang","sequence":"first","affiliation":[{"name":"Department of Cardiology, Cardiovascular Center, Cho Ray Hospital , No. 201B, Nguyen Chi Thanh Street, Ward 12, District 5, Ho Chi Minh City 70000 , Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3984-648X","authenticated-orcid":false,"given":"Sy Van","family":"Hoang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Center, Cho Ray Hospital , No. 201B, Nguyen Chi Thanh Street, Ward 12, District 5, Ho Chi Minh City 70000 , Vietnam"},{"name":"Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City , No. 217, Hong Bang Street, Ward 11, District 5, Ho Chi Minh City 70000 , Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,2,13]]},"reference":[{"key":"2023052507260034600_ytad076-B1","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1002\/ehf2.13701","article-title":"Thromboembolism and bleeding in systemic amyloidosis: a review","volume":"9","author":"Nicol","year":"2022","journal-title":"ESC Heart Fail"},{"key":"2023052507260034600_ytad076-B2","doi-asserted-by":"crossref","first-page":"2420","DOI":"10.1161\/CIRCULATIONAHA.107.697763","article-title":"Intracardiac thrombosis and embolism in patients with cardiac amyloidosis","volume":"116","author":"Feng","year":"2007","journal-title":"Circulation"},{"key":"2023052507260034600_ytad076-B3","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1093\/eurheartj\/ehab072","article-title":"Diagnosis and treatment of cardiac amyloidosis: a position statement of the ESC Working Group on Myocardial and Pericardial Diseases","volume":"42","author":"Garcia-Pavia","year":"2021","journal-title":"Eur Heart J"},{"key":"2023052507260034600_ytad076-B4","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1016\/j.jacc.2021.12.011","article-title":"2022 AHA\/ACC\/HFSA guideline for the management of heart failure: executive summary","volume":"79","author":"Heidenreich","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2023052507260034600_ytad076-B5","article-title":"High prevalence of intracardiac thrombi in cardiac amyloidosis","volume":"73","author":"Martinez Naharro","year":"2019","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2023052507260034600_ytad076-B6","doi-asserted-by":"crossref","first-page":"2490","DOI":"10.1161\/CIRCULATIONAHA.108.785014","article-title":"Intracardiac thrombosis and anticoagulation therapy in cardiac amyloidosis","volume":"119","author":"Feng","year":"2009","journal-title":"Circulation"},{"key":"2023052507260034600_ytad076-B7","doi-asserted-by":"crossref","first-page":"2910","DOI":"10.1016\/j.jacc.2019.02.078","article-title":"Predicting the unpredictable","volume":"73","author":"Russo","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2023052507260034600_ytad076-B8","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1080\/13506129.2020.1798922","article-title":"Arterial thrombo-embolic events in cardiac amyloidosis: a look beyond atrial fibrillation","volume":"28","author":"Cappelli","year":"2021","journal-title":"Amyloid"},{"key":"2023052507260034600_ytad076-B9","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1002\/ejhf.2566","article-title":"Systemic embolism in amyloid transthyretin cardiomyopathy","volume":"24","author":"Vilches","year":"2022","journal-title":"Eur J Heart Fail"},{"key":"2023052507260034600_ytad076-B10","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1002\/ehf2.12602","article-title":"Stroke risk and atrial mechanical dysfunction in cardiac amyloidosis","volume":"7","author":"Ballantyne","year":"2020","journal-title":"ESC Heart Fail"},{"key":"2023052507260034600_ytad076-B11","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1016\/j.jacc.2018.10.079","article-title":"Direct current cardioversion of atrial arrhythmias in adults with cardiac amyloidosis","volume":"73","author":"El-Am","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2023052507260034600_ytad076-B12","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.ijcard.2022.04.045","article-title":"Routine ambulatory heart rhythm monitoring for detection of atrial arrhythmias in transthyretin cardiac amyloidosis","volume":"358","author":"Dale","year":"2022","journal-title":"Int J Cardiol"},{"key":"2023052507260034600_ytad076-B13","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/j.jacc.2020.10.057","article-title":"Persistence of left atrial appendage thrombus in patients with cardiac amyloidosis","volume":"77","author":"El-Am","year":"2021","journal-title":"J Am Coll Cardiol"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytad076\/49171004\/ytad076.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/7\/5\/ytad076\/50436151\/ytad076.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/7\/5\/ytad076\/50436151\/ytad076.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T07:31:53Z","timestamp":1684999913000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytad076\/7035452"}},"subtitle":[],"editor":[{"given":"Luca","family":"Arcari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Giacomo Tini","family":"Melato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Vasilios","family":"Giampatzis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Emmanouil","family":"Mantzouranis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Tom","family":"Wardill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,2,13]]},"references-count":13,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,5,2]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytad076","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,5]]},"published":{"date-parts":[[2023,2,13]]},"article-number":"ytad076"}}