Patient In Chronic Hemodialysis With Right Atrial Mass: Thrombus, Fungal Endocarditis Or Atrial Myxoma?

Paciente Em Hemodiálise Crônica Com Massa Em átrio Direito: Trombo, Endocardite Fúngica, Ou Mixoma Atrial?

dc.creatorSalani
dc.creatorTalita G.; Borges
dc.creatorCynthia de Moura; Urbini
dc.creatorCarolina S.; Schincariol
dc.creatorPatrícia; Quadros
dc.creatorKélcia Rosana da Silva; Ribeiro-Alves
dc.creatorMaria Almerinda; Oliveira
dc.creatorRodrigo Bueno de
dc.date2016
dc.date2017-08-30T17:38:01Z
dc.date2017-08-30T17:38:01Z
dc.date.accessioned2018-03-29T05:31:02Z
dc.date.available2018-03-29T05:31:02Z
dc.identifierJornal Brasileiro De Nefrologia. Sociedade Brasileira De Nefrologia, v. 38, n. 4, p. 462 - 465
dc.identifier0101-2800
dc.identifierS0101-28002016000400462
dc.identifierhttp://www.scielo.br/scielo.php?pid=S0101-28002016000400462&script=sci_arttext&tlng=pt
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/324968
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1359186
dc.descriptionWe present the case report of a 19-year-old patient with chronic kidney disease due to chronic glomerulonephritis, in hemodialysis (HD) by central catheter, with the incidental finding of a mass of 28x16 mm in right atrium (RA). The diagnosis of thrombus, infective endocarditis or myxoma were considered. Given the context of immunosuppression and difficult access vascular therapeutic practice has proved complex. Although Doppler echocardiography suggested thrombus in RA, nuclear magnetic resonance imaging (MRI) indicated for the diagnosis of myxoma in RA. In both conditions, the proposed surgical approach was limited by intense immunosuppression history and the risk of infectious complications. Throughout the treatment, the general state of K.M.F. remained satisfactory and revealed no signs or symptoms related to atrial dysfunction. The absence of fever and negative blood cultures excluded infective endocarditis. Prior echocardiogram report without masses in the RA decreased the chance of cardiac myxoma. The therapeutic response to anticoagulation confirmed the diagnosis of thrombosis. After 180 days of anticoagulation, there was significant reduction in mass. The patient developed asymptomatic. The diagnosis of mass in RA can be a challenge and only the evolution of the case was able to guide the appropriate conduit. While MRI has high sensitivity and specificity for the diagnosis of cardiac myxoma, the interpretation of images can be subjective. Controversial point is the removal of the catheter in such cases, which is subject discussed throughout the report.
dc.description38
dc.description4
dc.description462
dc.description465
dc.languageIngles
dc.publisherSociedade Brasileira de Nefrologia
dc.relationJornal Brasileiro de Nefrologia
dc.rightsaberto
dc.sourceScielo
dc.subjectCatheters
dc.subjectEndocarditis
dc.subjectMyxoma
dc.subjectRenal Dialysis
dc.subjectThrombosis
dc.subjectCateteres
dc.subjectDiálise Renal
dc.subjectEndocardite
dc.subjectMixoma
dc.subjectTrombose
dc.titlePatient In Chronic Hemodialysis With Right Atrial Mass: Thrombus, Fungal Endocarditis Or Atrial Myxoma?
dc.titlePaciente Em Hemodiálise Crônica Com Massa Em átrio Direito: Trombo, Endocardite Fúngica, Ou Mixoma Atrial?
dc.typeComentário


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