IMAGES IN CARDIOVASCULAR ULTRASOUND J Cardiovasc Ultrasound 2013;21(3):152-153 Free Floating Left Atrial Thrombus Disappearing during Echocardiography

An 82-year-old woman with a history of previous cerebral infarction and atrial fibrillation was hospitalized with aphagia. Brain magnetic resonance imaging showed a dot-like high signal intensity in the left occipital subcortex. With a work-ing diagnosis of acute cerebral infarction due to cardiac embo-li, trans-thoracic echocardiography (TTE) was performed. The TTE showed an oval shaped, mobile thrombus, approximately 1.9 × 1.5 cm in size within the left atrial appendage. For fur-ther evaluation of mobile thrombus in the left atrial append-age, a trans-esophageal echocardiography (TEE) was done. The TEE showed an oval shaped, mobile thrombus in the left atrial appendage (Fig. 1A). Subsequently, during follow-up TTE, the thrombus was found to be freely floating in the left atrial cavity during each cardiac cycle (Fig. 1B-F and Supple