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"Pinball" Thrombus in the Left Atrium

Video Supplement to “Left Atrial 'Pinball' Thrombus Causing Recurrent Syncope,” by Suraci, et al.

A 75-year-old female with a history of rheumatic heart disease was admitted due to a syncopal episode. During the past 2 months, she reported 2 other sudden, brief episodes of syncope consistent with drop attacks. There were no premonitory symptoms suggestive of vasovagal syncope. TEE demonstrates severe mitral stenosis with a 5 x 5 cm, free-floating, left atrial thrombus intermittently obstructing the mitral valve orifice, which was bouncing off the mitral valve, much like a pinball.


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