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question

Question 11: What’s the best diagnosis in this patient with chest pain?

answer

Diagnosis: Thrombus in Atrial Appendage with Renal Infarct

"The frequency of left atrial thrombus in patients with recent emboli is comparable between those with acute and chronic atrial fibrillation. These data suggest that patients with acute atrial fibrillation for < 3 days require anticoagulation prophylaxis or evaluation by transesophageal echocardiography before cardioversion and should not be assumed to be free of left atrial thrombus."

Left atrial appendage thrombus is not uncommon in patients with acute atrial fibrillation and a recent embolic event: a transesophageal echocardiographic study.
J Am Coll Cardiol. 1995 Feb;25(2):452-9.
Stoddard MF, Dawkins PR, Prince CR, Ammash NM.

Thrombus in Atrial Appendage

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Clot in Atrial Appendage and PE

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Metastatic Chondrosarcoma to the Pulmonary Veins Extending into the Left Atrium and Appendage

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