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European Journal of Echocardiography 2008 9(1):199-200; doi:10.1093/ejechocard/jem074
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Uncommon intraventricular thrombus formation between the posterior mitral leaflet and the lateral left ventricular wall

Thomas Butz1,2,*, Lothar Faber2, Christoph Langer2, Hermann Esdorn3, Jan Körfer3, Marcus Wiemer2 and Dieter Horstkotte2

1 Department of Cardiology and Angiology, Marienhospital Herne, Ruhr University Bochum, D-44625 Herne, Germany
2 Department of Cardiology, Heart and Diabetes Center North Rhine—Westphalia, Ruhr University Bochum, Georgstrasse 11, D-32545 Bad Oeynhausen, Germany
3 Institute of Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine—Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany

Received 21 August 2007; accepted after revision 30 September 2007.

* Corresponding author. Tel: +49 2323 4990; fax: +49 2323 499-360. E-mail address: thomas.butz{at}marienhospital-herne.de


  Abstract

Transthoracic echocardiography demonstrated an intraventricular mass between the posterior mitral leaflet and the lateral left ventricular (LV) free wall in a 61-year-old man. Because of this uncommon localization an intracardial tumor, an endocarditis of the mitral valve or an intraventricular thrombus was suspected. Magnetic resonance imaging (MRI) ruled out an intracardial tumor and revealed a myocardial scarring of the LV free wall covered by an intraventricular thrombus by late gadolinium enhancement. MRI can distinguish subacute clots—which do not enhance after contrast material injection—from organized thrombi. The characterization of thrombi can be used to predict the risk of embolism, which is higher for subacute clots than for organized thrombi.

Keywords: Thrombus formation; Left ventricle; Echocardiography; Magnetic resonance imaging


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