PMC9262080_01
Trans-thoracic echocardiography in apical four-chamber view showing (A) large sausage-shaped mobile mass (34x11mm) arising from the left ventricular apex. B: repeat echocardiography after 2 weeks of dabigatran therapy showing complete resolution of thrombus.
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On admission, Transthoracic echocardiography (TTE) was done which showed a large sausage-shaped mobile mass (34x11mm) arising from the left ventricular apex with normal left ventricular systolic function (Figure 1A). On follow-up two-dimensional transthoracic echocardiography conducted after two weeks of dabigatran treatment, LV thrombus disappeared completely without further thromboembolic episode (Figure 1B).
A: Contrast-enhanced computed tomography scan with the arrow showing well-defined oval non-enhancing filling defect with smooth margins adjacent to the apex of the left ventricle possible thrombus. B: Cardiac MRI showing transmural (non-viable) infarct involving the anterior septum in apical and mid cavity level with apical thrombus.
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MRI were done to characterize the LV mass and it was consistent with LV thrombus. MRI also showed LV thrombus attached to transmural infarcted area involving anterior septum in apical and mid cavity level (Figure 2A and 2B).