“Hanging by a thread”: Thrombus or tumor in the right atrium as a cause of embolic stroke
DOI:
https://doi.org/10.37615/retic.v8n3a6Keywords:
thromboembolism, heart atria, patent foramen ovale, strokeAbstract
The Chiari network is an embryonic remnant located in the right atrium that was traditionally considered to be of no clinical significance. However, as in the case we are presenting, it can be a contributing factor in different pathologies. This is a 70-year-old female patient with a history of pulmonary thromboembolism and deep vein thrombosis who was admitted for an embolic stroke. The echocardiogram revealed a mass in the right atrium corresponding to a thrombus on Chiari’s network associated with a patent foramen ovale, which disappeared after several days of anticoagulation therapy. This case is a good example of how this structure can contribute to embolic phenomena and of the usefulness of echocardiography in its assessment.
Downloads
Metrics
References
Loukas M, Sullivan A, Tubbs RS, et al. Chiari’s network: review of the literature. Surg Radiol Anat. 2010;32(Suppl 10):895–901. https://10.1007/s00276-010-0639-z DOI: https://doi.org/10.1007/s00276-010-0639-z
Werner JA, Cheitlin MD, Gross BW, Speck SM, Ivey TD. Echocardiographic appearance of the Chiari network: differentiation from right-heart pathology. Circulation. 1981 May;63(5):1104-9. https://10.1161/01.cir.63.5.1104 DOI: https://doi.org/10.1161/01.CIR.63.5.1104
Manerikar A, Malaisrie SC. Chiari network and patent foramen ovale associated with stroke. JTCVS Tech. 2021 Nov 14;11:45-47. https://10.1016/j.xjtc.2021.11.006 DOI: https://doi.org/10.1016/j.xjtc.2021.11.006
Renani SA, Badalabadi RM, Abbasi Z, Gharebaghi M. Huge Chiari network in the right atrium diagnosed as thrombosis – case report and a brief review. J Cardiovasc Echogr. 2022 Apr-Jun;32(2):126-128. https://doi:10.4103/jcecho.jcecho_81_21 DOI: https://doi.org/10.4103/jcecho.jcecho_81_21
Martínez-Quintana E, Rodríguez-González F. Chiari Network and Paradoxical Embolism. Rev Esp Cardiol. 2014;67(11):922-3. https://doi:10.1016/j.rec.2014.09.018 DOI: https://doi.org/10.1016/j.rec.2014.09.018
Ribeiro R, Padrão M, Ferreira M, et al. Indicaciones actuales del cierre percutáneo del aurículo izquierdo en pacientes con fibrilación auricular y alto riesgo de accidente cerebrovascular. Rev Esp Cardiol. 2014;67(11):913-920. https://doi:10.1016/j.carcor.2013.05.007 DOI: https://doi.org/10.1016/j.carcor.2013.05.007
Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2021;42(5):373-498. https://doi:10.1093/eurheartj/ehaa612 DOI: https://doi.org/10.1093/eurheartj/ehaa798
Kleindorfer DO, Towfighi A, Chaturvedi S, Cockroft KM, Gutierrez J, Lombardi-Hill D, et al. 2021 Guideline for the prevention of stroke in patients with stroke and transient ischemic attack: A guideline from the American Heart Association/American Stroke Association. Stroke. 2021;52(7):e364-e467. https://doi:10.1161/STR.0000000000000375 DOI: https://doi.org/10.1161/STR.0000000000000375
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Mario José Recio Ibarz, Iván de María Mier , Flavio Augusto Gasparini Noriega, Sonia Peribáñez Belanche , Marta Antonio Martín
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
RETIC is distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) license https://creativecommons.org/licenses/by-nc-nd/4.0 which allows sharing, copying and redistribution of the material in any medium or format, under the following terms:
- Attribution: you must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests that the licensor endorses you or your use.
- Non-commercial: you may not use the material for commercial purposes.
- No Derivatives: if you remix, transform or build upon the material, you may not distribute the modified material.
- No Additional Restrictions: you may not apply legal terms or technological measures that legally restrict others from doing anything permitted by the license.
