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    Elusive left ventricular thrombus: Diagnostic role of cardiac magnetic resonance imaging-A case report and review of the literature

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    Author
    Siddiqui, Irfan; Nguyen, Tin; Movahed, Assad; Kabirdas, Deepa
    Abstract
    Identification of left ventricular mural thrombus (LVT) may be challenging depending on the imaging modality used. We present a case of LVT which was incidentally identified on cine cardiac magnetic resonance imaging (CMR). A sixty-four years old female presented with worsening dyspnea on exertion with troponin elevation. Transthoracic echocardiography (TTE) revealed a dilated left ventricle (LV) and ejection fraction (EF 30%) with thinning and akinesis of inferior/inferolateral wall was noted with basal and mid inferior wall aneurysm, and thrombus was not identified. CMR done to ascertain viability of myocardium revealed a mural thrombus within basal inferior aneurysm. This was not visualized on transthoracic echocardiography with and without use of contrast. She underwent coronary artery bypass grafting, bioprosthetic mitral valve replacement, resection and plication of posterior left ventricular aneurysm with removal of mural thrombus, and was started on anticoagulation with warfarin post-operatively for the apical thrombi. Cardiac magnetic resonance is a well suited imaging modality in detecting LVT due to its high resolution images and is more reproducible than TTE. In our patient, conventional TTE despite administration of echo-contrast agents failed to diagnose the presence of LVT in the basal inferior aneurysm as well as the apical thrombi. Delayed-enhancement CMR provides the greatest sensitivity for detection of left ventricular thrombus, superior to standard transthoracic and contrast-enhanced transthoracic echocardiography.
    URI
    http://hdl.handle.net/10342/8544
    Subject
    Left ventricular thrombus, Cardiovascular magnetic resonance, Transthoracic echocardiogram
    Date
    2018-06-16
    Citation:
    APA:
    Siddiqui, Irfan, & Nguyen, Tin, & Movahed, Assad, & Kabirdas, Deepa. (June 2018). Elusive left ventricular thrombus: Diagnostic role of cardiac magnetic resonance imaging-A case report and review of the literature. , (), - . Retrieved from http://hdl.handle.net/10342/8544

    Display/Hide MLA, Chicago and APA citation formats.

    MLA:
    Siddiqui, Irfan, and Nguyen, Tin, and Movahed, Assad, and Kabirdas, Deepa. "Elusive left ventricular thrombus: Diagnostic role of cardiac magnetic resonance imaging-A case report and review of the literature". . . (), June 2018. September 22, 2023. http://hdl.handle.net/10342/8544.
    Chicago:
    Siddiqui, Irfan and Nguyen, Tin and Movahed, Assad and Kabirdas, Deepa, "Elusive left ventricular thrombus: Diagnostic role of cardiac magnetic resonance imaging-A case report and review of the literature," , no. (June 2018), http://hdl.handle.net/10342/8544 (accessed September 22, 2023).
    AMA:
    Siddiqui, Irfan, Nguyen, Tin, Movahed, Assad, Kabirdas, Deepa. Elusive left ventricular thrombus: Diagnostic role of cardiac magnetic resonance imaging-A case report and review of the literature. . June 2018; (): . http://hdl.handle.net/10342/8544. Accessed September 22, 2023.
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