Moderate rheumatic mitral stenosis complicated by massive thrombus formation

AbstractAdvanced rheumatic mitral stenosis with enlarged left atrium and atrial fibrillation can predispose to the formation of thrombi over time, if anticoagulation treatment is ineffective. We present the case of a 66-year-old woman with atrial fibrillation and syncope. Moderate rheumatic mitral stenosis was diagnosed by echocardiography and two huge thrombi were incidentally revealed within the enlarged left atrium. CT scan of the brain did not demonstrate cerebral ischemia. The patient underwent early mitral valve replacement surgery and extirpation of the thrombotic masses. A pacemaker was implanted because of symptomatic bradyarrhythmia