Two-dimensional echocardiographic detection of biventricular thrombi

A 42-year-old man presented with acute myocardial infarction. The ECG on admission to hospital showed "Q wave" inferior myocardial infarction and "non-Q wave" anterior infarction. Subsequently, he was readmitted to hospital on many different occasions for cardiac failure. About 15 months after the patient was first seen, two-dimensional echocardiogram (2D echo) showed dilatation of all 4 cardiac chambers and severe global hypokinesia of the left ventricle. In addition, a large echo dense mass was seen at the apex of the left ventricle and 2 smaller echo dense masses were present at the right ventricular apex. The echocardiographic characteristics of these 3 masses strongly suggest that they represent mural thrombi. Two-dimensional echocardiographic detection of biventricular thrombi has rarely been described in the past. This case together with the previously reported case by Friedman and Buda suggest that 2D echo may be a valuable test for the diagnosis of biventricular thrombi.