Figure 2 – Thrombus in the LV apex in transthorasic echocardiography
Since thrombus formation in the normal left ventricle is a very rare condition, computerized tomography (CT) of the heart and coronary arteries was done as a second imaging modality to verify the intracardiac mass and see the coronary status for a possible thrombectomy operation. The coronary arteries were normal (Figure 3), and the thrombi were seen as a filling defect in the apex of the left ventricle in the CT (Figure 4). In addition to the heart findings, there were giant masses in the lungs which were interpreted as the sarcoma’s metastatic masses as described by the patient (Figure 5) .
The baseline biochemical tests did not show any hypercoagulable state, further tests as protein C, S, Factor V Leiden mutations, glycoprotein immunoglobulin antibodies, anticardiolipin antibodies could not be done because of the patient’s non-collaborative status. Lung sarcoma was accepted as the underlying reason of the spontaneous thrombus in the left ventricle.