Intracardiac Thrombi in Children: A Five-case Series and Literature Review

Abstract

Aims: The study reports a pediatric series of intracardiac thrombi and to discuss their clinical, diagnostic, and therapeutic aspects in the light of current literature. Study Design: Case series and literature review. Place and Duration of Study: Department of Pediatrics, Children’s Hospital, Rabat, Morocco, 2023–2024. Methodology: We retrospectively analyzed five pediatric patients aged 3 months to 13 years who were diagnosed with intracardiac thrombi of various etiologies. Clinical data, laboratory tests, imaging results, therapeutic strategies, and outcomes were collected from medical records. Results: The series included five children: one adolescent with hyperhomocysteinemia complicated by a left ventricular thrombus, a premature infant with a central venous catheter and right atrial thrombus, a 7‑month‑old with severe heart failure and left ventricular thrombus, a teenager with Behçet’s disease and right ventricular thrombus, and an infant with protein C/S deficiency and left ventricular thrombus. Management relied mainly on anticoagulation with low‑molecular‑weight heparin and vitamin K antagonists, alongside etiological treatments when indicated. Outcomes were variable: two patients died, two showed favorable recovery, and one was lost to follow‑up. Conclusion: Intracardiac thrombi in children are rare but potentially fatal conditions. Early recognition using echocardiography and timely initiation of anticoagulation are essential to prevent embolic complications. Prognosis depends on underlying pathology and rapid multidisciplinary management. Preventive strategies should address modifiable risk factors such as catheterization and uncorrected coagulation disorders.