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Updated: Jun 25, 2026
06:29
Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
"Hanging by a thread" left ventricular thrombus in an asymptomatic soldier
Mohammed A Chamsi-Pasha1, Ashraf M Anwar, Youssef F Nosir
1Department of Medicine, King Abdul-Aziz University, King Fahd Armed Forces Hospital, Jeddah, Kingdom of Saudi Arabia.
Saudi Medical Journal
|March 10, 2009
Summary
A mobile left ventricular mass resolved with anticoagulation therapy, avoiding surgery and complications. This case highlights a conservative approach for mobile cardiac masses in asymptomatic patients.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Thrombosis
Background:
- Mobile cardiac masses, particularly in the left ventricle, pose a significant risk of thromboembolic events.
- Transthoracic echocardiography is a key diagnostic tool for identifying cardiac masses.
- The optimal management strategy for mobile, asymptomatic left ventricular masses remains debated.
Observation:
- A 32-year-old asymptomatic soldier presented with an incidentally detected mobile, pedunculated left ventricular mass on echocardiography.
- The mass's mobility raised concerns for a high risk of embolization, prompting a recommendation for surgical removal.
Findings:
- The patient opted for anticoagulation therapy instead of surgery.
- The left ventricular mass completely resolved within 6 weeks of anticoagulation.
- No embolic or bleeding complications occurred during treatment.
- A 12-month follow-up revealed no recurrence of the thrombus.
Implications:
- Conservative management with anticoagulation may be a viable alternative to surgery for mobile left ventricular masses in select asymptomatic patients.
- This case suggests that anticoagulation can effectively resolve certain cardiac thrombi, reducing the need for invasive procedures.
- Further research is warranted to establish evidence-based guidelines for managing mobile cardiac masses.
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