Skip to main content
British Heart Journal logoLink to British Heart Journal
. 1983 Feb;49(2):122–132. doi: 10.1136/hrt.49.2.122

Thrombi in antrum atrii dextri of human heart as clinically important source for chronic microembolisation to lungs.

T N James
PMCID: PMC481273  PMID: 6824532

Abstract

In many cases of chronic microembolic pulmonary hypertension the source of the emboli is unknown. Disease or injury to the sinus node is usually accompanied by thrombus formation within the antrum atrii dextri, and this region is not often inspected carefully during necropsy. In the present study the hearts of 14 patients with right ventricular hypertrophy or documented pulmonary hypertension showed disease or injury in the sinus node, and each had both old and recent thrombosis in the antrum atrii dextri. In all 14 cases both lungs were available for histological examination. The group included six cases of rheumatic heart disease with mitral stenosis, four cases of disseminated lupus erythematosus, and four cases of so-called primary pulmonary hypertension. Every lung contained both new and old microemboli, as well as a wide variety of other histological abnormalities narrowing the small pulmonary arteries. Many of these narrowing lesions were recognisable as the consequence of prior microembolisation. For future postmortem examination of cases of chronic microembolic pulmonary hypertension, mural thrombi within the antrum atrii dextri should be considered as one important potential source for recurring microembolisation to the lungs.

Full text

PDF
122

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brisbane J. U., Howell D. A., Bonkowsky H. L. Pulmonary hypertension as a presentation of hepatocarcinoma. Report of a case and brief review of the literature. Am J Med. 1980 Mar;68(3):466–469. doi: 10.1016/0002-9343(80)90123-0. [DOI] [PubMed] [Google Scholar]
  2. Cushing E. H., Feil H. S., Stanton E. J., Wartman W. B. INFARCTION OF THE CARDIAC AURICLES (ATRIA): CLINICAL, PATHOLOGICAL, AND EXPERIMENTAL STUDIES. Br Heart J. 1942 Jan;4(1-2):17–34. doi: 10.1136/hrt.4.1-2.17. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Feller H. A., Janis J. F. Pulmonary hypertension, resulting from tumor emboli to pulmonary arteries. Dis Chest. 1968 Jul;54(1):68–70. doi: 10.1378/chest.54.1.68. [DOI] [PubMed] [Google Scholar]
  4. GEER J. C., GLASS B. A., ALBERT H. M. PULMONARY VASCULAR LESIONS IN THE DOG PRODUCED BY AUTOGENOUS CLOT EMBOLISM. Exp Mol Pathol. 1965 Aug;26:391–398. doi: 10.1016/0014-4800(65)90048-1. [DOI] [PubMed] [Google Scholar]
  5. JAMES T. N. Anatomy of the human sinus node. Anat Rec. 1961 Oct;141:109–139. doi: 10.1002/ar.1091410205. [DOI] [PubMed] [Google Scholar]
  6. JAMES T. N. Myocardial infarction and atrial arrhythmias. Circulation. 1961 Oct;24:761–776. doi: 10.1161/01.cir.24.4.761. [DOI] [PubMed] [Google Scholar]
  7. JAMES T. N. On the cause of syncope and sudden death in primary pulmonary hypertension. Ann Intern Med. 1962 Feb;56:252–264. doi: 10.7326/0003-4819-56-2-252. [DOI] [PubMed] [Google Scholar]
  8. JAMES T. N., RUPE C. E., MONTO R. W. PATHOLOGY OF THE CARDIAC CONDUCTION SYSTEM IN SYSTEMIC LUPUS ERYTHEMATOSUS. Ann Intern Med. 1965 Sep;63:402–410. doi: 10.7326/0003-4819-63-3-402. [DOI] [PubMed] [Google Scholar]
  9. James T. N., Birk R. E. Pathology of the cardiac conduction system in polyarteritis nodosa. Arch Intern Med. 1966 Apr;117(4):561–567. [PubMed] [Google Scholar]
  10. James T. N. The coronary circulation and conduction system in acute myocardial infarction. Prog Cardiovasc Dis. 1968 Mar;10(5):410–449. doi: 10.1016/s0033-0620(68)80002-7. [DOI] [PubMed] [Google Scholar]
  11. James T. N. The sinus node. Am J Cardiol. 1977 Dec;40(6):965–986. doi: 10.1016/0002-9149(77)90048-0. [DOI] [PubMed] [Google Scholar]
  12. Metcalfe D. D., Lewis R. A., Silbert J. E., Rosenberg R. D., Wasserman S. I., Austen K. F. Isolation and characterization of heparin from human lung. J Clin Invest. 1979 Dec;64(6):1537–1543. doi: 10.1172/JCI109613. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Mlczoch J., Tucker A., Weir E. K., Reeves J. T., Grover R. F. Platelet-mediated pulmonary hypertension and hypoxia during pulmonary microembolism: reduction by platelet inhibition. Chest. 1978 Dec;74(6):648–653. doi: 10.1378/chest.74.6.648. [DOI] [PubMed] [Google Scholar]
  14. Nair S. S., Askari A. D., Popelka C. G., Kleinerman J. F. Pulmonary hypertension and systemic lupus erythematosus. Arch Intern Med. 1980 Jan;140(1):109–111. [PubMed] [Google Scholar]
  15. Sack K. E., Bekheit S., Fadem S. Z., Bedrossian C. W. Severe pulmonary vascular disease in systemic lupus erythematosus. South Med J. 1979 Aug;72(8):1016–1018. doi: 10.1097/00007611-197908000-00037. [DOI] [PubMed] [Google Scholar]
  16. Sallam M., Watson W. C. Pulmonary hypertension due to micro-thromboembolism from splenic and portal veins after portacaval anastomosis. Br Heart J. 1970 Mar;32(2):269–271. doi: 10.1136/hrt.32.2.269. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. WARTMAN W. B., JENNINGS R. B., HUDSON B. Experimental arterial disease. I. The reaction of the pulmonary artery to minute emboli of blood clot. Circulation. 1951 Nov;4(5):747–755. doi: 10.1161/01.cir.4.5.747. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES