Left ventricular thrombus formation in a patient with normal ejection fraction

Left ventricular (LV) thrombi usually occur in the presence of impaired LV function, such as in dilated cardiomyopathy, aneurysm or following myocardial infarction. Thrombus formation in a normally functioning LV is extremely rare. We report a patient with LV thrombus formation despite a normal systolic function. The patient, who was admitted to the emergency service with transient loss of consciousness and diagnosed with cerebral embolism, was found to have a pedunculated and hypermobile mass in the LV apex by echocardiography. The LV mass was excised by urgent surgery due to its high embolic risk. The histopathological examination revealed that the LV mass was a thrombus. This case highlights that although very rare, LV thrombus formation may occur in patients with normal ejection fraction.