ASYMPTOMATIC LARGE LEFT-ATRIAL BALL THROMBUS - SECONDARY TO MITRAL-STENOSIS

We describe the very unusual case of a patient with a large, free-floa ting left-atrial thrombus secondary to severe mitral stenosis, in whom the peculiar symptoms and complications of a ball thrombus were absen t. The patient's only symptom before the episode reported here was mil d dyspnea, which was attributed to mitral stenosis. She experienced ne ither embolism nor syncope. While even her clinical signs did not indi cate a left-atrial ball thrombus, both echocardiography and angiograph y showed a free-floating thrombus. Because of the risk of stroke and a cute obstruction of the mitral valve, emergency surgery was performed upon diagnosis of the ball thrombus. The surgery, which consisted of r emoving the thrombus and replacing the mitral valve with a mechanical prosthesis, was uneventful. A computed tomographic brain scan prior to discharge did not detect any cerebral infarction.