DCMP complicated by LV
thrombus
DR. MOHAMMED AL-MARWALH
DR. ABEER ALSALABA
DR. AREEJ AL-JABALI
DR.RWA'A YASSEN
DR.ABDULAZIZ AONALLAH
Case presentation: DCMP complicated by
LV thrombus
 32 male patient, not known to have DM nor HTN,
ex-smoker but he is Qat chewer , pt gave history of
major stress 2 months ago there is no hx. Of
cardiovascular diseases in his family
patient was presented to the ER complaining of
atypical chest pain burning in nature associated with
lower limbs edema which was progressive in course
and abdominal distention
DCMP complicated by LV thrombus
 on Examination
patient was conscious oriented looks ill
not pale, not cyanosed, not jaundiced
there was mild lower limb edema
C.V.S=S1+S2+0
Chest= mild basal crepitation on RT side.,
Abdomen= soft
DCMP complicated by LV thrombus
 investigations
CBC,RFT,LFT were within normal
cardiac enzymes normal
ECG showed= sinus rhythm, Lt. axis deviation Lt.
arterial enlargement, poor R wave progression In
anterior leads
LVH with strain pattern by voltage criteria
DCMP complicated by LV thrombus
 ECHO=
DCMP complicated by LV thrombus
 ECHO=
DCMP complicated by LV thrombus
 ECHO=
 global hypocontractility
 moderate LV impairment
 very large mural fresh mobile Thrombus occupying
more than 60% of the left ventricle cavity
 moderate MR, Mild TR
DCMP complicated by LV thrombus
 Diagnosis:
DCMP complicated by LV thrombus.
 The plan of management of this patient were
anticoagulant and anti heart failure treatment
DCMP complicated by LV thrombus
 AFTER MANAGEMENT :
Picture of the thrombus after the management
AFTER MANAGEMENT :
AFTER MANAGEMENT :
AFTER MANAGEMENT :
Dr.Mohammed ALMarwala