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European Journal of Echocardiography 2008 9(1):86-87; doi:10.1016/j.euje.2007.02.003
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2007. For permissions please email: journals.permissions@oxfordjournals.org.

Acute heart failure and near-syncope associated with giant left atrial ball thrombus occluding left ventricular inflow tract

Kenan Yalta*, Ahmet Yilmaz, Okan Onur Turgut, Mehmet Birhan Yilmaz, Filiz Karadas, Gokhan Bektasoglu and Izzet Tandogan

Department of Cardiology, Cumhuriyet University, Sivas 58100, Turkey

Received 28 December 2006; accepted after revision 4 February 2007; online publish-ahead-of-print 22 March 2007.

* Corresponding author. Tel: +90 5056579856. E-mail address: kyalta{at}gmail.com


  Abstract

A 70-year-old female patient was admitted to our department with symptoms and signs of acute heart failure and near syncope. After hospitalization, both transthoracic echocardiography (TTE) and subsequent transesophageal echocardiography (TEE) demonstrated a giant (4.9x3.9 cm) mobile, irregular, bright left atrial mass consistent with left atrial ball thrombus (LABT).The mass was found to occlude the left ventricular inflow tract (LVIT) above the mitral orifice (supravalvular) in the presence of normal mitral leaflets. After emergent surgical excision, the pathology of the left atrial mass was found to be consistent with thrombus. The case presented here suffered acute diastolic heart failure and near-syncope due to obstruction of the LVIT above the mitral orifice by a giant LABT.

Keywords: Left atrial ball thrombus; Acute heart failure; Near-syncope


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