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Calcified left ventricular thrombus causing repeated retinal arterial emboli: clinical, echocardiographic, and
Insights
A young adult experienced vision loss due to a calcified left ventricular thrombus. Echocardiography revealed a large mass, confirmed surgically as a thrombus, highlighting diagnostic challenges.
Area of Science:
- Cardiology
- Ophthalmology
- Pathology
Background:
- Left ventricular thrombi (LVT) can cause embolic events, leading to significant morbidity.
- Diagnosis of LVT, especially calcified forms, can be challenging, impacting treatment strategies.
Observation:
- A young adult male presented with a two-year history of transient visual field defects, culminating in left eye vision loss.
- Clinical presentation was investigated using M-mode and cross-sectional echocardiography.
Findings:
- Echocardiographic studies revealed a large mass occupying the left ventricle.
- Surgical exploration confirmed the presence of a discrete calcified mass, pathologically identified as a calcified thrombus.
Implications:
- This case underscores the importance of considering LVT in young adults with embolic phenomena, even with atypical presentations.
- Echocardiography is a crucial tool for diagnosing LVT, though calcified thrombi may present diagnostic challenges.
- Prompt surgical intervention can be curative, preventing further embolic complications.
Abstract:
The clinical, echocardiographic, and pathologic features of a discrete calcified left ventricular thrombus are presented in a young adult man with a two-year history of transient visual field defects leading to eventual loss of vision in his left eye. M-mode and cross-sectional echocardiographic studies suggested a large mass extending across the left ventricle. These findings were confirmed at surgery when a calcified mass pathologically consistent with a calcified thrombus was removed. The pertinent literature on the echocardiographic diagnosis of left ventricular thrombi is reviewed.