Why the study?
Nonapical left ventricular thrombus is extremely rare and leads to diagnostic confusion with tumors or vegetations.
Multimodality imaging including MRI is useful for diagnosing unusually located LV thrombi, allowing for successful conservative management with oral anticoagulation.
Nonapical LV masses warrant multimodality imaging to exclude thrombus; this case leaves open generalizability of medical resolution.
Left ventricular (LV) cavity mass is common in clinical practice. Most of the time, it is a thrombus at the LV apex. Nonapical location of mass leads to confusion in the diagnosis with possibilities of tumors or vegetations. Here, we describe a case of LV thrombus in an extremely unusual location. Multimodality images helped us to come to a proper diagnosis. The mass vanished completely from LV cavity with medical management. Our case is unique, as presentation of clot was at very unusual location, only few such cases have been reported in literature. With the help of multimodality imaging, we were able to successfully manage the case conservatively with oral anticoagulation. Left ventricular thrombus is a common complication in patient with ischemic or nonischemic cardiomyopathy. Nonapical location of a thrombus is not only extremely rare but also creates diagnostic confusion. Although echocardiography is a screening imaging modality of choice, magnetic resonance imaging is extremely useful before planning surgical versus nonsurgical treatment option.
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Gurmukhani et al. (2020) studied this question.
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