Discussion
Left ventricular thrombus with normal systolic functions is a very rare
condition. Only 31 cases were reported with male predominance (%58)
(1). The predisposing factors are inflammatory conditions, malignancies,
blood dyscrasias, hypercoagulable states as lupus anticoagulant and
diagnostic work-up for these situations are advised (1). The apex of the
left ventricle is the most common site of thrombus in the ischemic and
non-ischemic myocardium and although there are no guidelines or
recommendation reports for the treatment of left ventricular thrombus in
patients with normal systolic functions, anticoagulation therapies with
or without surgical removal is recommended for these patients. The
anticoagulation algorithms advised for intracardiac thrombus in the
reduced left ventricle functions might be used. As the United States
guidelines recommend the usage of a vitamin K antagonist with a target
level of INR between 2.0-2.5 or dabigatran, rivaroxaban or apixaban for
3 months, European guidelines recommend the treatment up to 6 months
(2-6).