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A 58 year old woman with a one year history of antiphospholipid syndrome and ineffective anticoagulant treatment (international normalised ratio 1.2) was admitted with pain in the left hypochondrium. Abdominal ultrasound revealed a 5 cm wide splenic infarction. Transoesophageal echocardiography showed mobile masses resembling bunches of grapes on both the mitral and the tricuspid valves (panels A and B, and video 1—to view video footage go to http://www.heartjnl.com/supplemental). On control transoesophageal echocardiography after six weeks of effective anticoagulation, these masses almost entirely disappeared from both valves (panel C and video 2). The patient showed no signs or symptoms of embolism during the same period.
Two video sequences accompany this article. To view the videos use the links below.
Files in this Data Supplement:
- [View Video] - Video A Mitral and tricuspid valve thrombi
- [View Video] - Video B 6 weeks later