PMC6481144_01
EKG shows atrial fibrillation and LBBB.
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Electrocardiogram (EKG) showed atrial fibrillation with new left bundle branch block (LBBB) (Figure 1).
(a) CXR showed cardiomegaly with pulmonary congestion and bilateral pleural effusion. (b) CT chest with contrast showed moderately large bilateral pleural effusions, right greater than left, with cardiomegaly and reflux of IV contrast into the IVC, consistent with cardiogenic pulmonary vascular congestion.
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Chest X-ray (CXR) and computed tomography (CT) of the chest showed cardiomegaly and moderate pleural effusion in bilateral lung fields (Figure 2).
(a) The TEE transesophageal short axis view shows a large multilobulated mobile thrombus in the left atrial appendage. (b) TEE done 3 months later shows resolution of the thrombus.
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TEE revealed a large multilobulated mobile thrombus in the left atrial appendage, and sessile irregular echogenic material attached to the wall of the left atrium was visualized (Figure 3(a)). On subsequent outpatient follow-up three months later, repeat TEE showed no visible thrombus (Figure 3(b)).