PMC7278298_01
Cardiac magnetic resonance imaging (cMRI) series: (a) Transverse section with left circle encapsulating pleural and lung metastases and center circle encapsulating the right atrial thrombus, (b) coronal section with white circle enveloping the large right atrial thrombus also demonstrating its heterogeneous appearance, (c) sagittal section with white circle enveloping the large right atrial thrombus again demonstrating its heterogeneous appearance, and (d) transverse section indicating the encircled pedunculated heterogeneous thrombus attached by a stalk from the right atrial free wall.
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It also revealed a large right atrial thrombus (3.8 cm x 2.5 cm x 3.2 cm) without overt pulmonary emboli (see Figures 1 and 2). A transesophageal echocardiogram and cardiac MRI (magnetic resonance imaging) confirmed the presence of the right atrial thrombus (see Figures 1 and 2) with a preserved ejection fraction and no McConnell's sign.
Transesophageal echocardiography (TEE) imaging series: (a-c) 90 , 120 , and 180  bicaval views, respectively, with a circle encapsulating the large right atrial thrombus, demonstrating a heterogeneous appearance; (d) 90  bicaval view demonstrating the dimensions of the right atrial thrombus before initiation of therapy.
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It also revealed a large right atrial thrombus (3.8 cm x 2.5 cm x 3.2 cm) without overt pulmonary emboli (see Figures 1 and 2). A transesophageal echocardiogram and cardiac MRI (magnetic resonance imaging) confirmed the presence of the right atrial thrombus (see Figures 1 and 2) with a preserved ejection fraction and no McConnell's sign.
Computed tomography imaging (CT) series: (a) Transverse view demonstrating the encircled residual thrombus burden, which has been considerably attenuated by direct oral anticoagulation with rivaroxaban for 3 months and (b) sagittal view again demonstrating the residual thrombus burden.
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During this period, she underwent six cycles of gemcitabine and capecitabine chemotherapy, and a subsequent computed tomography scan 3 months later revealed near-complete right atrial thrombus dissolution (1.1 cm x 2.1 cm x 0.9 cm) (see Figure 3).