A case of biventricular thrombi in a patient with dilated cardiomyopathy: Utility of multimodality imaging for diagnosis and management of treatment strategy

Publication date: Available online 22 November 2016 Source:Journal of Cardiology Cases Author(s): Takayuki Iwano, Kei Yunoki, Noriyuki Tokunaga, Masataka Shigetoshi, Hiroki Sugiyama, Hiroyuki Yamamoto, Jun Kondo, Mikizo Nakai, Masahiro Okada, Hiromi Matsubara A 54-year-old man was transferred to our hospital due to congestive heart failure and left ventricular thrombi. Transthoracic echocardiography (TTE) showed mobile “ball-like” not only left ventricular but also right ventricular thrombi associated with severe impaired left and right ventricular function. Contrast-enhanced computed tomography (CT) and cardiac magnetic resonance imaging (MRI) also detected biventricular apical thrombi complicated with right renal infarction. Coronary angiography showed non-significant stenosis. Due to the mobility of thrombi and complication of systemic infarction, the surgical transatrial video-assisted removal of biventricular thrombi was performed and postoperative course has been uneventful over a period of 6 months. Endomyocardial biopsy performed during an operation showed no specific findings such as endomyocarditis, indicating the diagnosis of dilated cardiomyopathy (DCM). This is a rare case of DCM complicated with biventricular apical thrombi detected clearly by multimodality imaging such as TTE, contrast-enhanced CT and cardiac MRI, and surgical removal was performed successfully. <Learning objective: The incidence of biventricular thrombi is rare and has b...
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research