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Point-of-Care Ultrasound Diagnosis of Left Ventricular Thrombus: A Case Series

Tyler H Wen1, Alina Mitina1, Di Coneybeare1

  • 1Department of Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, USA.

Cureus
|August 4, 2025
PubMed

Insights

Point-of-care ultrasound (POCUS) can identify left ventricular thrombus in the emergency department, aiding early diagnosis. This rapid detection in heart failure patients may prevent serious complications.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Medical Imaging

Background:

  • Left ventricular thrombus (LVT) is a serious complication of heart failure and myocardial infarction.
  • Diagnosing LVT in the emergency department (ED) is challenging due to limited access to advanced imaging like MRI.
  • Timely LVT diagnosis is crucial to prevent ischemic end-organ events.

Observation:

  • This case series presents three patients with confirmed LVT diagnosed using point-of-care ultrasound (POCUS) in the ED.
  • POCUS provided critical diagnostic information for emergency physicians, facilitating communication with consulting teams.
  • The patients presented with diverse underlying conditions, including non-ischemic cardiomyopathy, ischemic cardiomyopathy, and cerebrovascular occlusions.

Findings:

  • POCUS demonstrated effectiveness in visualizing LVT across different cardiac pathologies within the ED setting.
  • The findings highlight POCUS as a valuable tool for rapid LVT assessment in emergency situations.
  • Successful POCUS identification of LVT enabled prompt management discussions.

Implications:

  • Early LVT detection via POCUS can expedite patient management and potentially improve outcomes.
  • This approach may enhance the diagnostic capabilities of emergency physicians for LVT.
  • Further research is warranted to establish the impact of POCUS-guided LVT management on patient morbidity and mortality.

Keywords:
cardiomyopathyleft ventricular aneurysmleft ventricular thrombuspoint-of-care ultrasoundthromboembolic events

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