PMC6501232_01
Computed tomography scan of the heart showing the free-floating ball-shaped thrombus (arrow) and appendage thrombus (arrow head). They look blurred due to movement within the left atrium.
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fig1
The woman was referred to the department of cardiology with consultation for left atrial masses detected by chance with follow-up echocardiography and computed tomography (Figure 1).
Two-dimensional transesophageal echocardiographic images of the free-floating ball-shaped mass (arrows), left (arrow heads), and right (*) atrial appendage thrombi. LA: left atrium; LAA: left atrial appendage; LV: left ventricle; RA: right atrium; RAA: right atrial appendage.
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fig2
With the subsequent evaluation by transesophageal echocardiography, using an x8-2t transducer on an EPIQ 9 ultrasound machine (Philips Medical Systems, Andover, MA, USA), 2 atrial thrombi occupying the left and right atrial appendage cavities, respectively, in addition to the free-floating round-shaped mass were found (Figure 2).
Three-dimensional transesophageal echocardiographic image of the free-floating ball-shaped mass (arrow) around which some sludge (arrow heads) is present suggesting a potential mechanism of its formation. Abbreviations are the same as in Figure 2.
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fig3
With the real-time 3-dimensional transesophageal echocardiographic imaging, the round-shaped mass was ascertained to be ball-shaped (Figure 3).
Three-dimensional transesophageal echocardiographic images of the left (arrow heads) and right (arrows) atrial appendage thrombi. Abbreviations are the same as in Figure 2.
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fig4
The 3-dimensional images of both appendage thrombi are shown in Figure 4.
PMC6501232_02