Case Report: Tetris Ball In The Left Atrium

A free-floating ball thrombus in the left atrium is a rare and serious medical problem that can cause fatal systemic emboli or block the flow of blood into the left ventricle, which usually ends in sudden death.This report discusses a case of a significant left atrial thrombus that was found to be free-floating in an enlarged left atrium. A 73-year-old male, who had experienced a cerebrovascular infarction and hemorrhage five days earlier, along with a history of chronic atrial fibrillation, was referred to the cardiology department to investigate the embolic cause. A transthoracic echocardiogram identified a free-floating ball thrombus. Thrombolytic therapy was not recommended because there were areas of bleeding within the cerebrovascular infarction and the patient had a high risk profile The individual, with several comorbid conditions, a Glasgow Coma Scale score of 8, and right-sided hemiplegia, was classified as high-risk by the cardiovascular surgery team. In spite of the potential for bleeding complications, treatment with warfarin and unfractionated heparin was started. Subsequent evaluations indicated that the thrombus did not diminish in size. We lost our patient due to progressive heart failure and cardiogenic shock while anticoagulant treatment was continuing. As a result, in such cases, it is important to determine the treatment according to the patient's general condition, glaskow coma score, embolization and the risk of fatal bleeding.