An unusual thrombus in a patient with arrhythmogenic cardiomyopathy

Herein we present a case of a right ventricular (RV) thrombus in a patient with arrhythmogenic cardiomyopathy (ACM). The 24-year old female patient was diagnosed with ACM after echocardiography, genetic test and cardiac magnetic resonance imaging. Interestingly, at echocardiography, an unusal thrombus formation was detected at RV lateral wall. Also, CMR confirmed the thrombus and oral anticoagulant therapy was started. During the patient's follow-ups, it was observed that the imaging consistent with the reported thrombus disappeared after effective anticoagulant treatment. After the diagnosis was confirmed with genetic tests, an implantable cardioverter-defibrillator (ICD) was implanted in the patient with a high sudden cardiac death (SCD) risk score. Even in arrhythmogenic right ventricular cardiomyopathy patients thrombi are rarely reported. However, the development of imaging techniques may enable more frequent detection and effective treatment of thrombi in these patients.