Biventricular thrombi in dilated cardiomyopathy: massive simultaneous pulmonary and systemic embolisation

A patient with biventricular thrombus formation in dilated cardiomyopathy suffered massive combined systemic and pulmonary embolization shortly after oral anticoagulation was started. Although this can be coincidental, it can also suggest that the basis of a thrombus may dissolve first with any, including oral, anticoagulation. In unusual conditions surgical removal of thrombi in dilated cardiomyopathy may be a safer alternative.