PMC7675891_01
Chest X-ray showed multifocal opacities bilaterally.
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Multifocal opacities were appreciated in the chest X-ray (Figure 1).
CT angiogram of the chest showed right upper lobe segmental and
subsegmental emboli.
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Computed tomography (CT) angiogram of the chest revealed right upper lobe segmental and subsegmental emboli, suggestions of multiple thrombi in the left ventricle, and multifocal ground-glass opacities (Figure 2).
Echocardiogram revealed a large thrombus of a diameter of 3 cm in
the apical region of the left ventricle.
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Echocardiogram was done for further evaluation which revealed a large thrombus of a diameter of 3 x 3 cm in the apical region of the left ventricle, and an ejection fraction of 20%-25% with signs of left ventricular hypertrophy (Figure 3), normal right ventricular systolic function with no signs of right heart strain, and no evidence of any thrombus in the right heart chambers or any valvular heart disease.
Echocardiogram 3 months prior to his presentation with no signs of
left ventricular thrombus.
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Three months before his presentation, the patient had a two-dimensional (2D) echocardiograph with no evidence of thrombus in the left ventricle, with the same ejection fractions and the signs of left ventricular hypertrophy (Figure 4).
Repeated echocardiogram after 6 weeks post discharge which showed a
significant reduction in the size of the left ventricular
thrombus from 3 cm to 1 cm.
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Six weeks later, echocardiography was repeated and showed a significant reduction in the size of the left ventricular thrombus from 3 x 3 cm to 1 x 1 cm (Figure 5), and the patient was recommended to continue the treatment to complete at least 6 months duration, where another echocardiogram will be done to re-assess the situation A full hypercoagulability workup showed mildly elevated anticardiolipin antibodies IgM 57.