Left Ventricular “Horseshoe-Thrombus”—A Case Report

Thrombi represent the most frequently found intracardiac masses. Left ventricular thrombus (LVT) is an important complication in patients with ischemic heart diseases and in those with dilated cardiomyopathy and systolic heart failure. The diagnosis of left ventricular thrombus remains important since anticoagulation will reduce the risk of systemic embolization and stroke. Despite advances in other imaging modalities, echocardiography remains the most important tool for diagnosis and risk stratification in patients predisposed to develop left ventricular thrombi. Mural thrombi formed on the left ventricular endocardium and horseshoe-shaped in chronic dilated cardiomyopathy, masquerading as left ventricular endomyocardial fibrosis was diagnosed by transthoracic 2D echocardiographic imaging in a 38 years old middle aged man. Background of this case highlighted the pathophysiology, high risk echocardiographic features and the role of anticoagulant therapy in LV thrombus with dilated cardiomyopathy.