A 56-year-old female with a history of progressive shortness of breath and rheumatic fever was admitted for stroke. The ECG revealed atrial fibrillation and intravenous anticoagulation with un-fractionated Heparin was initiated. Transthoracic echocardiography revealed a large highly mobile mass in the left atrium, suspicious for thrombus (arrow, Fig. 1A), and severe mitral valve stenosis. Transoesophageal echocardiography showed a floating mass, without evidence of attachment, pushed back in the left atrial cavity by the thickened and restricted mitral valve leaflets like a sort of "pinball" (Fig. 1B and 1C and movie clips 1 -2).
展开▼
