CHA[2]DS[2] -VASc score as a predictor of left atrial thrombus in patients with non-valvular atrial fibrillation

To investigate whether or not the CHA[2]DS[2] -VASc score predicts left atrial [LA] thrombus detected on pre-cardioversion transoesophageal echocardiography [TEE]. The medical records of patients who had undergone TEE were reviewed to assess the presence of LA thrombus prior to direct-current cardioversion for atrial fibrillation [AF]. The CHA[2]DS[2] -VASc score was calculated for each patient. Clinical TEE reports were reviewed for the presence of LA thrombus. Patients with a valve prosthesis or rheumatic mitral valve disease were excluded from this study. A total of 309 patients were identified. The mean age was 70.1 +/- 9.8 years and 151 [49%] patients were males and 158 [51%] were females. LA thrombus was seen in 32 [10.3%] of the 309 patients. Fifty [16.2%] patients had a low CHA[2]DS[2] -VASc score [0-1], 230 [74.4%] had an intermediate score [2-4] and 29 [9.4%] had a high score [5-9]. The incidence of LA thrombus in the low, intermediate and high CHA[2]DS[2] -VASc score groups was 0, 4.4 and 68.7%, respectively. The LA thrombus risk increased with increasing CHA[2]DS[2] -VASc scores. On multivariate logistic analysis, the CHA[2]DS[2] -VASc score [OR 3.26, 95% CI 2.3-4.65; p = 0.001] and age [OR 0.93, 95% CI 0.88-0.98; p = 0.004] were independent risk factors for LA thrombus in patients with non-valvular AF. A high CHA[2]DS[2] -VASc score was independently associated with the presence of LA thrombus in patients with non-valvular AF

Comorbidity of constrictive pericarditis and hemophilia A

To report a case of comorbidity of constrictive pericarditis and hemophilia A. Clinical Presentation and Intervention: A 21-year-old male with hemophilia A was referred to our clinic and was examined with the subsequent evaluation of shortness of breath, leg edema and ascites. Clinical and laboratory examinations were performed. The results were consistent with constrictive pericarditis [CP], and the symptoms were completely relieved following institution of medical therapy. Because hemophilia A and pericarditis may be coincidentally present clinical conditions, avoidance of surgical procedures in hemophilic patients is preferable unless the resolution of the symptoms of pericarditis cannot be effected by medical therapy