[Floating thrombus in the left atrium. Apropos of a clinical case]

The authors report a case of floating left atrial thrombus, detected by transthoracic echocardiography, in a 63 years old patient with moderate mitral stenosis and atrial fibrillation. He was admitted to hospital, with supraventricular tachyarrhythmia and pulmonary edema. There was no previous syncope or thromboembolism episodes. Apparently the anticoagulant therapy wasn't interrupted. The diagnosis of the free floating left atrial thrombus was made by two-dimensional echocardiography. Predisposing factors, clinical course and echocardiographic diagnosis are discussed. The risk of prolonged engagement of the thrombus in the mitral orifice, causing syncope or sudden death, justifies urgent surgery associating thrombectomy and treatment of mitral stenosis.