Abstract
Aexertional dyspnea, and a history of diarrhea. Echocardiography revealed a large intracavitary thrombus occupying the apical two thirds of the left ventricular (LV) cavity (Fig 1A) and severely elevated LV filling pressures. The mitral valve was mildly thickened, with significant subvalvular tethering. Further imaging with computed tomography and magnetic resonance imaging confirmed these findings (Fig 1B, C, D). Stool samples tested positive for Strongyloides stercoralis larvae. She was taken to the operating room with the diagnosis of endomyocardial fibrosis secondary to hypereosinophilia caused by the Strongyloides infection. Right and left ventricular apical thrombus and fibrotic tissue were identified and aggressively excised. The mitral valve was immobile because of the intense reaction and involvement of the thrombus, with the subvalvular apparatus necessitating
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