Left atrial appendage thrombus in a term neonate with ventricular dysfunction

Left atrial appendage thrombosis is exceedingly rare in neonates and may present with nonspecific findings. We report a term neonate presenting with poor feeding and a gallop rhythm, who was found to have a large left atrial appendage thrombus with ventricular dysfunction. Surgical excision resulted in rapid recovery, highlighting the importance of early echocardiographic evaluation in subtle neonatal heart failure.