Interesting cases

Oct 2023 - Came across largest LA clot I have witnessed so far. About 10 X 8cm!!! Yes that's the size of clot. Needless to say that the LA was huge. The patient still not willing for any intervention, nor for admission despite being in acute heart failure. There were financial constraints. But even after giving option of getting treated at govt hospital, he chose not to take treatment. Convincing patients to get proper medical care is a tough job at peripheral centers. It's made tougher by misinformation spread by many, including many local practitioners.

date 18.11.2023 : A patient admitted in an unconscious state, with anisocoria, gasping for breath. CT ruled out bleed. Patient improved steadily. Regained consciousness over few hours- had only minimal hemiparesis after 8 hours. Extubated. Her echo showed highly mobile LV clot- A scary thick chord attached to heart muscle trying to escape free from shackles and ready to jump into blood flow. After discussion with my colleagues and mentor, I decided to anticoagulate cautiously. Responded very well to anticoagulation. Size came down from 4cm to 1cm in just 5 days. A great experience to share the good news with relatives.

date 22.11.2023. Did a rescue PTCA. An experience to proceed on background of almost no clotting of blood where mistakes may become unforgiving. Patient did well.