Related Experiment Video
Updated: May 12, 2026

Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
Mobile left ventricular thrombus in left ventricular dysfunction: case report and review of literature
Jürgen Leick1, Sebastian Szardien, Christoph Liebetrau
1Department of Cardiology, Kerckhoff Heart and Thorax Center, Benekestr. 2-8, 61231 Bad Nauheim, Germany.
Introduction:
Left ventricular (LV) thrombi carry a high risk of embolization. Therapeutic recommendations like treatment with low molecular heparin and intravenous unfractionated heparin (UFH), thrombolysis or surgical thrombectomy have failed to reach a consensus.
Case Description:
A 56-year-old female patient presented in cardiogenic shock to the emergency department. Echocardiography demonstrated a dilated LV with a severely depressed global systolic function and a large LV apical thrombus. Treatment with UFH was initiated as well as a treatment with catecholamines for stabilizing the patient's hemodynamic situation. On the follow-up echocardiographic examination, extensive free-floating parts of the thrombus could be documented. Given the high risk of embolization in a now hemodynamically stable situation, emergency surgical embolectomy was performed.
Discussion:
A conservative procedure might be useful for bridging till surgical treatment is available and/or the risk due to surgery is acceptable.
Conclusion:
In absence of evidence-based guidelines for the treatment of LV thrombi, individualized management options concerning surgical, embolization and bleeding risk must be taken into account.
Related Concept Videos
Cardiomyopathy III: Hypertrophic Cardiomyopathy
Mitral Valve Prolapse I: Introduction
Mitral Regurgitation II: Clinical Features and Diagnostic Tests
Cardiomyopathy I: Introduction and Classification
Mitral Valve Prolapse II: Assessment and Management
Mitral Regurgitation I: Introduction
