Large atrial appendage thrombus in the presence of severe mitral regurgitation: contradictory hemodynamics or expected findings

Abstract

A case of a large left atrial appendage thrombus in the presence of severe mitral regurgitation is presented. The use of transesophageal echocardiography in this setting was not only useful but also crucial despite the low anticipated diagnostic yield given the expected altered left atrial flow dynamics from the turbulent regurgitant lesion. However, additional confounding factors could have acted as potential mechanisms to enhance thrombosis in this setting and consequently are discussed.