International Journal of Cardiovascular ResearchISSN: 2324-8602

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Clinical Image, Int J Cardiovasc Res Vol: 9 Issue: 4

Free Floating Atrial Thrombus

Sofía S. Sánchez1* and Luis Apac2

1National Institute of Neurological Sciences, Lima, Peru

2Department of Cardiology, National Institute of Neurological Sciences, Lima, Peru

*Corresponding Author: Dr. Sofia S. Sánchez
National Institute of Neurological Sciences, Lima, Peru
Tel: 943860188

Received: June 15, 2020 Accepted: July 08, 2020 Published: July 15, 2020

Citation: Sánchez SS, Apac L (2020) Free Floating Atrial Thrombus. Int J Cardiovasc Res 9:4.. doi: 10.37532/icrj.2020.9(4).407


This case shows us the utility to perform a cardiac ultrasound to exclude free atrial thrombus, also it shows us that in patients who are not able to have a surgery, the medical management with anticoagulation could be considered as a safe option.

Keywords: Thrombus; Stroke; Anticoagulation.


A 75-year-old man presented to the emergency department with a history of 5 hours of weakness of the right side of the body and face. Physical examination showed a right hemiparesis and right hemihipoestesia. Brain magnetic resonance imaging showed multiple infarcts. The Holter study showed atrial fibrillation. Subsequent transthoracic echocardiography showed a large, mobile atrial mass thrombus of 4.3x2.7cm at the left atrium, he was treated with apixaban 5mg every 12 hours, while he was waiting for the evaluation of cardiothoracic surgery, he had 2 strokes more that were shown in the MRI, 4 weeks after starting the treatment, while he was waiting for surgery, a transthoracic echocardiogram control was performed and it had not shown any thrombus. One month after, at the consultatory room, the patient was asymptomatic and at the echocardiogram, there was not any thrombus (Figure 1,2).

Figure 1: Transthoracic ecocardiography (A) Subcostal four-chamber view showing the free-floating thrombus (B)Apical view showing the thrombus.

Figure 2: One-month follow-up transthoracic ecocardiography showing no thrombus.

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