North Texas Research Forum 2025
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Division
North Texas
Hospital
Medical City Arlington
Specialty
Internal Medicine
Document Type
Poster
Publication Date
2025
Keywords
left ventricular thrombus, LVT
Disciplines
Cardiovascular Diseases | Internal Medicine | Medicine and Health Sciences
Abstract
Introduction: Left Ventricular thrombus (LVT) is one of the most feared complications post myocardial infarction due to the high incidence of embolization. LVT typically form after myocardial infarction and the presence of low ejection fraction (EF), both of which contribute to Virchow’s triad for thrombus formation. LVT are less common in the absence of these risk factors or pre-existing cardiovascular disease. This case report explores the incidental discovery of LVT in a patient, without any known cardiovascular disease, who presented for treatment of acute pancreatitis. Case Presentation: 42-year-old male with past medical history of alcohol use disorder and recurrent pancreatitis who presented with acute abdominal pain and elevated pancreatic enzyme levels. Initial management and evaluation was focused on pancreatitis due to patient’s history of multiple hospital visits for treatment of condition. CT Abdomen and Pelvis was obtained and showed a filling defect in the left ventricle. Further evaluation with transthoracic echocardiography showed a 25mm x 13 mm mobile mass as well as severe akinesis of the apical walls. Due to concerns for thrombus, MRI Brain was also obtained, which showed subacute infarct in left occipital lobe. Patient had left heart catheterization performed but there were no findings of obstructive coronary artery disease. He was transferred to a tertiary care center for further evaluation with Cardiac MRI. Patient was discharged on Eliquis with instructions to follow up with cardiology outpatient. Patient returned to original facility four weeks later for abdominal pain. On second admission, patient reported non-compliance with Eliquis due to cost and lifestyle choices. Repeat MRI Brain revealed new small infarcts. Learning Point: LVT is a rare finding in the absence of cardiac risk factors such as MI or low EF. Patients with alcohol use history are at risk of developing dilated cardiomyopathy and hypokinesis of the apical wall, which can increase the risk of LVT development
Original Publisher
HCA Healthcare Graduate Medical Education
Recommended Citation
Yeung, Chak Lam; Gandi, Shivani; Al-Ezzi, Shakir; Huang, Nicole; and Pragyan, Adhikari, "Out of Left Field LV Thrombus: Incidental Finding in Patient Presenting with Abdominal Pain" (2025). North Texas Research Forum 2025. 42.
https://scholarlycommons.hcahealthcare.com/northtexas2025/42