Abstract
Intracardiac thrombi develop relatively frequently in adult patients, especially with atrial fibrillation or pulmonary embolism. The management of such patients is specified in detail in national and international agreement documents. In children, the description of blood clots of this localization is limited to individual clinical cases, and, as a result, there are no practical recommendations for their treatment and monitoring. The main causes of intracardial thrombosis in children are serious chronic diseases, hereditary thrombophilia and the consequences of COVID-19. The article presents a detailed review of the available literature data and our own clinical experience in managing patients in this category.
References
- Kropacheva E.S. Intracardiac thrombosis: frequency, risk factors and place of oral anticoagulants in treatment. Atherothrombosis. 2020; (1): 134–52 (in Russ.). DOI: 10.21518/2307-1109-2020-1-134-152.
- Konstantinides S.V., Meyer G., Ecattini C., Bueno H., Geersing G.-J., Harjola V.-P. et al.; ESC Scientific Document Group. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS): the Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC). Eur. Heart J. 2020; 41 (4): 543–603. DOI: 10.1093/eurheartj/ehz405
- Monagle P., Cuello C.A., Augustine C., Bonduel M., Brandão L.R., Capman T. et al. American Society of Hematology 2018 Guidelines for management of venous thromboembolism: treatment of pediatric venous thromboembolism. Blood Adv. 2018; 2 (22): 3292–316.
- Stein P.D., Kayali F., Olson R.E. Incidence of venous thromboembolism in infants and children: data from the National Hospital Discharge Survey. J. Pediatr. 2004; 145 (4): 563–5. DOI: 10.1016/j.jpeds.2004.06.021
- Harvey K.A., Xu Z., Pavlina T.M., Zaloga G.P., Siddiqui R.A. Modulation of endothelial cell integrity and inflammatory activation by commercial lipid emulsions. Lipids Health Dis. 2015; 14: 9. DOI: 10.1186/s12944-015-0005-6
- Derevnina Yu.V. Intracardiac thrombosis in chronic heart failure children with cardiomyopathy with dilated phenotype. Rossiiskiy Pediatricheskiy Zhurnal (Russian Pediatric Journal). 2019; 22 (3): 162–9 (in Russ.). DOI: 10.18821/1560-9561-2019-22-3-162-169
- Revel-Vilk S., Yacobovich J., Tamary H., Goldstein G., Nemet S., Weintraub M. et al. Risk factors for central venous catheter thrombotic complications in children and adolescents with cancer. Cancer. 2010; 116: 4197–205. DOI: 10.1002/cncr.25199
- Emad Y., Ragab Y., Kechida M., Guffroy A., Kindermann M., Robinson C. et al. A critical analysis of 57 cases of Hughes-Stovin syndrome (HSS). A report by the HSS International Study Group (HSSISG). Int. J. Cardiol. 2021; 331: 221–9. DOI: 10.1016/j.ijcard.2021.01.056
- Mogulkoc N., Burgess M.I., Bishop P.W. Intracardiac thrombus in Behcet’s disease: a systematic review. Chest. 2000; 118: 479–87. DOI: 10.1378/chest.118.2.479
- Raffini L. Thrombophilia in children: who to test how when and why? Hematology Am. Soc. Hematol. Educ. Program. 2008: 228–35. DOI: 10.1182/asheducation-2008.1.228
- Avila M.L., Amiri N., Stanojevic S., Vu T.T., Barron K., Krol P. et al. Can thrombophilia predict recurrent catheter-related deep vein thrombosis in children? Blood. 2018; 131 (24): 2712–9. DOI: 10.1182/blood-2017-10-8-11216
- van Ommen C.H., Nowak-Göttl U. Inherited thrombophilia in pediatric venous thromboembolic disease: why and who to test. Front Pediatr. 2017; 5: 50. DOI: 10.3389/fped.2017.00050
- Kukhtinova N.V., Ivanov S.N. Intracardiac thrombi as a new variant cardiovascular injury in a previously healthy COVID-19 child: сase report and follow up. The Eurasia Proceedings of Health, Environment and Life Sciences (EPHELS). 2022; 7: 26–9. DOI: 10.55549/ephels.45
- COVID-19 dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). Available at: https://coronavirus. jhu.edu/map.html (accessed November 22, 2023).
- Ong M., Wu A.C., Bourgeois F.T. Enrollment of Pediatric Patients in COVID-19 Interventional Trials. JAMA Health Forum. 2023; 4 (11): e233939. DOI: 10.1001/jamahealthforum.2023.3939
- Madjid M., Safavi-Naeini P., Solomon S.D., Vardeny O. Potential effects of coronaviruses on the cardiovascular system: a review. JAMA Cardiology. 2020; 5 (7): 831–40. DOI: 10.1001/jamacardio.2020.1286
- Information for healthcare providers about multisystem inflammatory syndrome in children (MIS-C). Centers for Disease Control and Prevention. https://www.cdc.gov/mis/hcp/index.html (accessed November 22, 2023).
- Lippi G., Lavie C.J., Sanchis-Gomar F. Cardiac troponin in coronavirus disease 2019 (COVID-2019): evidence from a metaanalysis. Progress in Cardiovascular Diseases. 2020; 63 (3): 390–1. DOI: 10.1016/j.pcad.2020.03.001
- Chen C., Zhou Y., Wang D.W. SARS-CoV-2: a potential novel etiology of fulminant myocarditis. Herz. 2020; 45 (3): 230–2. DOI: 10.1007/s00059-020-04909-z 20. Trapani S., Rubino C., Lasagni D., Pegoraro F., Resti M., Simonini G., Indolfi G. Thromboembolic complications in children with COVID-19 and MIS-C: a narrative review. Front. Pediatr. 2022; 10: 944743. DOI: 10.3389/fped.2022.944743
- Lasagni D., Nosadini M., Molinari A.C., Saracco P., Pelizza M.F. et al.; Systemic Thromboses Working Group of the Italian Registry of Pediatric Thrombosis (RITI Registro Italiano Trombosi Infantili). Systemic Catheter-Related Venous Thromboembolism in Children: Data From the Italian Registry of Pediatric Thrombosis. Front. Pediatr. 2022; 10: 843643. DOI: 10.3389/fped.2022.843643
- Gigante B., Levy J.H., van Gorp E., Bartoloni A., BochatonPiallat M.-L., Bäck M. at al. Management of patients on antithrombotic therapy with severe infections: a joint clinical consensus statement of the ESC Working Group on Thrombosis, the ESC Working Group on Atherosclerosis and Vascular Biology, and the International Society on Thrombosis and Haemostasis. Eur. Heart J. 2023; 44 (32): 3040–58. DOI: 10.1093/eurheartj/ehad388
- McDonagh T.A., Metra M., Adamo M., Gardner R.S., Baumbach A., Böhm M. et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur. Heart J. 2021; 42 (36): 3599–726. DOI: 10.1093/eurheartj/ehab368
- Features of clinical manifestations and treatment of the disease caused by a new coronavirus infection (COVID-19) in children: methodological recommendations. Version 2 (07/03/2020). Moscow: Ministry of Health of Russia. Available at: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/050/914/original/03062020_дети_COVID-19_v2.pdf (accessed November 22, 2023) (in Russ.).
About the authors
- Natalya V. Kukhtinova, Cand. Med. Sci., Associate Professor of the Department of Pediatrics; ORCID
- Sergey N. Ivanov, Dr. Med. Sci., Professor, Leading Researcher; ORCID
