Free-floating left ventricular and fixed left atrial thrombus.

摘要

A 69-year-old male patient presented to the emergency room with altered mental status. He had a history of a bioprosthetic mitral valve placement for severe mitral regurgitation. Neurologic examination revealed an evidence of focal neurologic deficits corresponding to multiple vessel territories. A computed tomography scan of head revealed multiple ischemic infarcts in the cerebellum, thalamus, and pons. An echocardiogram performed at this time showed a ball thrombus in left atrium and a free-floating snake-shaped thrombus in left ventricle (Figure 1). Surgical intervention was not undertaken because of patient's poor medical status. The patient subsequently developed bilateral proximal femoral artery occlusions while on anticoagulation. He progressively deteriorated and expired a few days later.