Giant biventricular thrombi in a patient with heart failure and heparin-induced thrombocytopenia

Abstract

A 59-year-old man with a two month history of progressive dyspnea was admitted with biventricular decompensated heart failure. Echocardiography on admission revealed dilatation of all cardiac chambers and severe biventricular systolic dysfunction (left ventricular ejection fraction 15%, right ventricular fractional area change 9%) as well as thrombi in both the left (Fig. 1, Panel A, showing apical four chamber view, and Panel B, showing parasternal short axis view) and right ventricle. Treatment with heparin and aspirin as well as heart failure medication were established.