Abstract
We report a case of a 67-year-old man who presented to urgent care with a one-week history of left-sided abdominal pain and oliguria. Over the past month, he reported feeling fatigued as well as noticed decreased urine output. The patient does have a significant cardiac medical history that includes coronary artery disease with a previous myocardial infarction, reduced ejection fraction, and hypertension. Imaging studies were conducted which revealed the likely etiology of his current symptoms. A transthoracic echocardiogram (TTE) revealed the presence of a large non-mobile apical thrombus occupying most of the apex of the left ventricle. Computed Tomography (CT) confirmed an apical left ventricular thrombus and showed decreased perfusion to the spleen and ischemia/infarction of the left kidney. The patient was initially treated with heparin but subsequently given enoxaparin with bridging to warfarin. He began to feel better with less left flank pain. Although this presentation of an LV thrombus is a rare occurrence, it is important for physicians to consider abdominal pain as a presenting complaint.
Highlights
Left ventricular (LV) thrombus can manifest as a complication of LV dysfunction
Factors V and VIII are responsible for forming clots, and when they are indirectly inactivated by the upstream warfarin, the risk of developing blood clots decreases [6]
The patient was treated with heparin that was bridged to warfarin which resolved the symptoms [8]
Summary
Corresponding Author: Leonard Ranasinghe, MD Address: College of Medicine, California Northstate University, 9700 West Taron Drive, Elk Grove, California 95757. Email: Received date: 05 June 2021; Accepted date: 26 June 2021; Published date: 02 July 2021 Asp Biomed Clin Case Rep. 2021 Jul 02;4(2):114
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