Inferior Vena Cava Obstruction by a Cardiac Mass: Unusual Presentation of Primary Antiphospholipid Syndrome

Abstract

We present a previously healthy 43-year-old woman with a cardiac mass that caused almost total occlusion of the inferior vena cava at its junction with the right atrium. The resected mass proved to be a thrombus. Preoperative imaging tests could not distinguish it from other intracardiac tumors such as myxoma. A postoperative immunological study revealed a primary antiphospholipid syndrome. This case presents an unusual diagnosis of antiphospholipid syndrome and a rare location of a cardiac thrombus.

Key words

Antiphospholipid syndrome - intracardiac mass - thrombus - inferior vena cava

References

• 1 George D, Erkan D. Antiphospholipid syndrome.  Prog Cardiovasc Dis. 2009;  52 (2) 115-125
• 2 Cervera R, Piette J C, Font J et al. Euro-Phospholipid Project Group. Antiphospholipid syndrome: clinical and immunologic manifestations and patterns of disease expression in a cohort of 1000 patients.  Arthritis Rheum. 2002;  46 1019-1027
• 3 Roubey R A. New approaches to prevention of thrombosis in the antiphospholipid syndrome: hopes, trials, and tribulations.  Arthritis Rheum. 2003;  48 (11) 3004-3008
• 4 Basso C, Bottio T, Rubino M et al. Antiphospholipid syndrome and right atrial mass.  J Thorac Cardiovasc Surg. 2005;  130 (5) 1462-1463