The use of Apixaban for the treatment of an LV thrombus.

A 42 year old male was admitted with shortness of breath secondary to suspected heart failure and chest infection. An echocardiogram revealed a dilated and impaired left ventricle; ejection fraction 29%, with a large, mobile thrombus within the left ventricular apex. Due to the presence of liver dysfunction, vitamin K antagonists were deemed inappropriate, thus the decision was taken to use the novel anticoagulation agent Apixaban. After six days of receiving Apixaban, a cardiac magnetic resonance scan was preformed which showed complete resolution of the LV apical thrombus.