Intracardiac thrombi may develop after myocardial infarction or in patients with atrial fibrillation. Left ventricular thrombus typically follows an anterior myocardial infarction, whereas left atrial appendage thrombus is more common in patients with atrial fibrillation. Specific factors which may lead to ventricular thrombus include aneurysm of the ventricle wall and severe regional wall motion abnormalities.
Morphology and clot density should distinguish the intracardiac thrombus from normal papillary muscle.
This patient was urgently referred to hospital for cardiology review. He underwent an echocardiogram which proved the presence of a patent foramen ovale.