Клинический случай внутрисердечного тромбоза на фоне перенесенной инфекции SARS-COV-2

А.А. Плешко, Т.В. Статкевич, Е.Б. Петрова, Н.П. Митьковская

УО «Белорусский государственный медицинский университет», ГУ «РНПЦ «Кардиология», г. Минск

Трудно переоценить урон человеческим жизням и здоровью прошагавшей по Миру пандемии COVID-19. По данным Всемирной организации здравоохранения (ВОЗ), было зарегистрировано более 500 млн подтвержденных случаев инфицирования SARS-CoV-2, более 6 млн из которых имели летальный исход. Высокая частота артериальных тромбозов и венозных тромбоэмболических осложнений, нередко приводящих к гибели пациентов с новой коронавирусной инфекцией SARS-CoV-2, несмотря на проводимую антитромботическую терапию, свидетельствует о необходимости углубленного изучения патогенетических моментов прокоагулянтного статуса и более рационального персонифицированного подхода к профилактическим мероприятиям у данной категории лиц. Особый интерес вызывает развитие тромботических осложнений у реконвалесцентов COVID-19.
В статье представлен клинический случай 43-летнего мужчины без сердечно-сосудистого анамнеза, у которого в течение месяца после перенесенной коронавирусной инфекции развился вирусный миокардит с формированием тромбов в полостях сердца, флеботромбоз глубоких вен нижних конечностей, как следствие – тромбоэмболия легочной артерии.
В статье рассмотрены ведущие патофизиологические механизмы, которые могут привести к развитию тромбоза и тромбоэмболических осложнений у пациентов с COVID-19.

ключевые слова: COVID-19, SARS-CoV-2, внутрисердечный тромбоз, миокардит, ТЭЛА.

для цитирования: А.А. Плешко, Т.В. Статкевич, Е.Б. Петрова, Н.П. Митьковская. Клинический случай внутрисердечного тромбоза на фоне перенесенной инфекции SARS-CoV-2. Неотложная кардиология и кардиоваскулярные риски, 2022, Т. 6, № 1, С. 1539–1546.

A clinical case of intracardiac thrombosis associated with SARS-COV-2 infection

A. Pleshko, T. Statkevich, E. Petrova, N. Mitkovskaya

The damage to humanity and global healthcare done by the COVID-19 pandemic is hard to overestimate. According to the World Health Organization (WHO), there were more than 500 million confirmed cases of SARS-CoV-2 infection, more than 6 million of which were fatal. The high incidence of arterial thrombosis and venous thromboembolic complications despite the ongoing antithrombotic therapy, often leading to death in patients with new coronavirus infection SARS-CoV-2, indicates the need for profound study of the pathogenetic aspects of procoagulant status and a more rational personalized approach in prophylactic measures in this category of patients. Special interest is the development of thrombotic complications in COVID-19 convalescents.
This article presents a clinical case of a 43-year-old man with no car-diovascular history who suffered viral myocarditis with thrombus formation in the heart cavities, thrombosis of deep veins of the lower extremities and consequent pulmonary thromboembolism, all of which developed within a month after coronavirus infection. In the article authors discuss the leading pathophysiological mechanisms that potentially could propagate the development of thrombosis and thromboembolic complications in patients with COVID-19.

keywords: COVID-19, SARS-CoV-2, intracardiac thrombosis, myocarditis, pulmonary embolism.

for references: A. Pleshko, T. Statkevich, E. Petrova, N. Mitkovskaya. A clinical case of intracardiac thrombosis associated with SARS-CoV-2 infection. Neotlozhnaya kardiologiya i kardiovaskulyarnye riski [Emergency cardiology and cardiovascular risks], 2022, vol. 6, no. 1, pp. 1539–1546.

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