Daily 10 mg rivaroxaban as a therapy for ventricular thrombus related to left ventricular non-compaction cardiomyopathy

Figure 1. Serial echocardiographic images in the identification of a left ventricular thrombosis-like mass. (A) Identification of a thrombus at the left ventricular apex during the initial echo examination, leading to the initialization of rivaroxaban (10 mg daily) treatment. Crossed lines surrounded the thrombus-like mass, which is also indicated by an arrow. (B) After 15 days of treatment, the size of the thrombus was reduced. (C) At 45 days of anticoagulation therapy, the size of the thrombus was further reduced. (D) The thrombus had diminished after 3 months, revealing suspected increased intratrabacular recesses of the heart (blue arrows). (E) Doppler imaging revealed a “flushed” pattern of blood flow into the myocardium.

Figure 2. Cardiac magnetic resonance image showing evidence of ventricular non-compaction. Arrows indicate the non-compacted ventricle. The ratio between non-compaction to compaction of the ventricular myocardium is >2.3 at the end of diastole, which is one of the diagnostic criteria for LVNC.[15]