PMC4062986_01
(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
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F1
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].
PMC4062986_02
(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
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F2
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 UFH was withdrawn two weeks later upon disappearance of all intracardiac thrombi [Figure 2d].