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A 21-year-old woman with a history of rheumatic fever at 7 years of age presented with left-sided weakness. A large ischemic infarction involving the territory of the right middle cerebral artery was diagnosed. Cardiac evaluation revealed atrial fibrillation. Echocardiography showed normal aortic, pulmonic, and tricuspid valves, severe mitral stenosis with a valve area of 0.9 cm2, and a large free-floating ball-valve thrombus in the dilated (to 5 cm in diameter) left atrium (Panels A and B, arrows), which partially obstructed the mitral valve intermittently (Panels C and D, arrows, and video). After initial stabilization, the patient was treated . . . [Full Text of this Article] |
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