Embolic Accident Following Heparin Therapy for a Left Ventricular Clot Diagnosed by TEE:

There are few data available on the incidence of embolic events inpatients with systemic anticoagulation. We describe a 40-year-old woman in congestive heart failure who was shown by transesophageal echocardiography to have an apical thrombus in the left ventricle without concomitant aneurysm. The patient was started on heparin immediately after the diagnosis was established. Twelve hours later she developed an embolic cerebrovascular accident. We believe that heparin dislodged the thrombus as occurs occasionally with thrombolytic agents used in the treatment of acute myocardial infarction.
transesophageal echocardiography, paradoxical embolization with heparin treatment, left ventricular thrombus