2.1 Diagnostic workup
During the hospital stay, the patient underwent diagnostic and
therapeutic workup as appropriate (Figure 1). High-resolution computed
tomography (HRCT) revealed multiple peripheral patchy ground glass
opacities at both lung fields associated with pneumonic consolidation
(Figure 2). The patient received the standard treatment of COVID-19
pneumonia with no need for mechanical ventilation.
Persistant fever and tachycardia with elevated D-dimer and
thrombocytopenia indicated bedside transthoracic echocardiography (TTE)
which revealed large mobile tricuspid valve mass, mostly thrombus,
measuring 33 x 17 mm and protruding into right atrium (RA) and right
ventricle (RV), with moderate-to-severe TR and moderate pulmonary
hypertension. Furthermore, cardiac magnetic resonance (CMR) showed TVT
of 28 x 21 x 11mm oscillating into the right ventricle with preserved
ventricular function (Figure 3). Blood culture showed no growth.