Appearance of Thrombus in Both Ventricles.

A 42-year-old woman with no remarkable medical history and no history of thrombosis was hospitalized for edema. Transthoracic echocardiography revealed a diffusely hypocontractile left ventricle (ejection fraction 26%). Echo images depicted thrombus at the left ventricular apex (16×12 mm) and base (18×14 mm) and the right ventricle (48×15 mm). Brain natriuretic peptide was 4386 pg/ml, D-dimer was 1.45 μg/dL, and protein C activity was 61% (normal range, 70-140%). Contrast-enhanced computed tomography revealed intracardiac masses, no contrast effect on these masses, and no other abnormalities (Picture 1). Coronary angiography detected three-vessel disease. She was diagnosed with multiple thrombi due to decreased blood flow in the heart caused by the decreased contraction of both the ventricles as a result of ischemic heart disease. Heparin and warfarin were started, and the thrombi were reduced (Picture 2). This is the first report including computed tomography images of simultaneous ventricular thrombus owing to three-vessel disease (1).

Picture 1.

Picture 2.

The authors state that they have no Conflict of Interest (COI).