Unusual thrombi in the setting of rheumatic heart disease

We report two patients with unusual intracavitary thrombi in association with rheumatic mitral stenosis. One patient had a large free-floating left atrial thrombus immediately after successful closed mitral valvotomy causing recurrent acute pulmonary oedema in the post-operative phase. The other patient was detected to have multiple, discrete and calcified left ventricular thrombi in the presence of severe left ventricular systolic dysfunction. The diagnosis in both cases was made by cross-sectional echocardiography.