A free-floating left atrial thrombus develops intermittent entrapment in the mid-ventricle during diastole

Heart Vessels. 2012 Jul;27(4):428-31. doi: 10.1007/s00380-011-0199-0. Epub 2011 Nov 2.

Abstract

Free-floating left atrial thrombi are rare. Here we report a case of a 75-year-old woman with atrial fibrillation who was admitted for treatment of acute myocardial infarction. A free-floating left atrial thrombus was found incidentally on echocardiography. Ten days after percutaneous coronary intervention, the patient had mild faintness with transient hypotension, and it was found that the left atrial thrombus had developed intermittent entrapment in the mid-ventricle during diastole, with abrupt rebound back to the left atrial cavity during systole. Urgent removal of the thrombus was performed successfully. Although the free-floating thrombus had appeared to be spherical, like a ball thrombus, on echocardiography, the excised thrombus was pedunculated. A cut section revealed a laminated thrombus with an onion-skin-like appearance.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary
  • Anticoagulants / therapeutic use
  • Atrial Fibrillation / diagnosis*
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / therapy
  • Diastole*
  • Echocardiography, Transesophageal
  • Female
  • Heart Diseases / diagnosis*
  • Heart Diseases / physiopathology
  • Heart Diseases / therapy
  • Humans
  • Hypertrophy, Left Ventricular / diagnosis*
  • Hypertrophy, Left Ventricular / physiopathology
  • Hypertrophy, Left Ventricular / therapy
  • Incidental Findings
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / therapy
  • Predictive Value of Tests
  • Thrombectomy
  • Thrombosis / diagnosis*
  • Thrombosis / physiopathology
  • Thrombosis / therapy
  • Treatment Outcome
  • Ventricular Dysfunction, Left / diagnosis*
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Dysfunction, Left / therapy
  • Ventricular Function, Left*

Substances

  • Anticoagulants