Left ventricle intracavitary thrombus in a patient with dilated cardiomyopathy

Melgarejo J.A.; Granados N.A.C.; Rojas C.H.R.; Quezada J.C.R.; Flores H.M.V. · Medicina Interna de Mexico (2025) · DOI: 10.24245/mim.v1i2.9411

Resumen

BACKGROUND: The formation of a thrombus in the left ventricle is a serious complication of ischemic cardiomyopathies and less prevalent in non-ischemic ones. Ventricular dysfunction, present in both diseases, determines the fulfillment of Virchow's triad, mainly blood stasis, which leads to thrombus formation and the subsequent development of thromboembolic complications such as stroke. CLINICAL CASE: A 23-year-old male patient with a history of ischemic stroke of undetermined etiology who attended the emergency room with atypical symptoms and signs of decompensated heart failure. During his hospitalization, non-ischemic dilated cardiomyopathy was diagnosed, and the presence of an intracavitary thrombus in the left ventricle with severe systolic dysfunction was evident according to echocardiographic, tomographic findings, and cardiac magnetic resonance studies with late gadolinium enhancement. CONCLUSIONS: Despite the advances in medicine in recent years, dilated cardiomyopathy continues to be a disease whose etiology is difficult to elucidate, especially in low-resource countries; so, suspicion should be high in ischemic events of obscure etiology.

Instituciones: Universidad Científica del Sur; Universidad Ricardo Palma; Universidad César Vallejo