Figure 1. Transthoracic echocardiogram, apical four-chamber view, shows a large mobile 3.2 x 1.7 cm mass (arrow) protruding from the left atrial appendage, consistent with mural thrombus
A transthoracic echocardiogram showed a large mobile mass 3.2 x 1.7 cm protruding from left atrial appendage, consistent with mural thrombus (figure 1). Concentric left ventricular wall and right ventricular free-wall thickening with a granular, ‘sparkling’ appearance of the myocardium was noticed. The left ventricle (LV) was globally hypokinetic with a reduced LV ejection fraction of 40%. There was thickening of the cardiac valves and atrial septum, dila