Embolization of a left ventricular mural thrombus: verification by two-dimensional echocardiography

A two-dimensional (2-D) echocardiogram in a 69-year-old man disclosed a septal-apical left ventricular thrombus six days after an acute anterior wall myocardial infarction. On the ninth hospital day, he suddenly experienced left-sided weakness and a left-sided field cut consistent with the diagnosis of a cerebrovascular accident (CVA). A repeated 2-D echocardiogram showed that the original mural thrombus had completely disappeared, which strongly supported an embolic event as the cause of the CVA. Two-dimensional echocardiography helped to verify the cause of this patient's neurologic problem. The mechanism and predisposing factors that led to a systemic embolism are discussed.