Giant pedunculated thrombus with normal left ventricular systolic function mimicking myxoma

A 74-year-old woman with a history of essential thrombocythemia was admitted to the Coronary Care Unit because of atypical chest pain. The transthoracic echocardiogram showed normal left ventricular (LV) diameter and preserved regional and global systolic function. A pedunculated mobile mass measuring 25 mm × 14 mm was visualized in the LV cavity, attached to the midanterior wall. Because of the typical echocardiographic appearance, a myxoma was suspected. The patient evolved with left hemiparesis and negative T-waves in the electrocardiogram. Left ventriculotomy with excision of the ventricular mass was performed. Histopathological examination revealed an organized thrombus.