case_images: PMC4062986_01
case_images: (a) Transthoracic echocardiography, Apical 4-chamber view, Multiple intracardiac thrombus in the right atrium, right ventricle and left ventricle, (b) Transoesophageal echocardiography, mid-oesophageal view. A thrombus or intramural hematoma with mobile particles in the posterior wall of the descending aorta, (c) Transoesophageal echocardiography, upper-oesophageal view. A large thrombus in right atrium, (d) Transthoracic echocardiography, Apical 4-chamber view. No evidence of residual thrombus
case_images: HV-15-22-g001.jpg
case_images: PMC4062986_01_HV-15-22-g001.jpg
case_images: F1
case_images: Two-dimensional echocardiogram revealed a dilated left ventricle (LVED: 63 mm, LVES: 55 mm) with severe diffuse hypokinesis, depressed left ventricle ejection fraction (30%, biplane Simpson method), mild mitral and tricuspid regurgitation, and multiple thrombi: Apical thrombi in both ventricles with the left ventricular apical thrombus and mobile, a mural left ventricular thrombus, and a right atrial thrombus [Figure 1a-c]. Transesophageal echocardiogram (TOE) was performed which revealed a thrombus or intramural hematoma with mobile particles in the posterior wall of the descending aorta and dense spontaneous echo contrast in the descending aorta [Figure 1b]. A follow-up transthoracic and transesophageal echocardiogram at one month, showed no evidence of residual thrombus [Figure 1d].
case_images: PMC4062986_02
case_images: (a and b) Transoesophageal echocardiography, mid-oesophageal view. Multiple intracardiac thrombus in the right atrium, (c) Transthoracic echocardiography, Apical 4-chamber view. A large thrombus in right atrium, (d) Transthoracic echocardiography, Apical 4-chamber view. No evidence of residual thrombus
case_images: HV-15-22-g002.jpg
case_images: PMC4062986_02_HV-15-22-g002.jpg
case_images: F2
case_images: Transesophageal echocardiography confirmed multiple thrombi: A 1.6 x 1.5 cm mural thrombus in the right atrium near the superior vena cava and a 1.5 x 0.8 cm thrombus in the right atrium near the inferior vena cava [Figure 2a-c]. UFH therapy, was followed up by repeated transesophageal echocardiograms. UFH was withdrawn two weeks later upon disappearance of all intracardiac thrombi [Figure 2d].