# Right and Left Ventricle Thrombus in a 68-Year-Old Patient With Sepsis and Cardiomyopathy

## TL;DR

A 68-year-old woman with sepsis and heart disease developed blood clots in both heart chambers, highlighting the need for early diagnosis and advanced imaging.

## Contribution

This case report highlights the rare occurrence of bilateral ventricular thrombi in septic cardiomyopathy and emphasizes the role of CMR in diagnosis.

## Key findings

- The patient had thrombi in both right and left ventricles due to septic cardiomyopathy.
- Echocardiography had limitations, while CMR provided superior diagnostic clarity.
- Treatment with heparin led to symptomatic improvement in the patient.

## Abstract

Right ventricular thrombus (RVT) is a rare but clinically significant condition associated with severe complications, such as pulmonary embolism and right heart failure. This case report presents a 68-year-old woman with a history of diabetes, coronary artery disease, and heart failure with reduced ejection fraction (HFrEF), who developed bilateral ventricular thrombi in the context of septic cardiomyopathy secondary to a diabetic foot infection and a urinary tract infection (UTI). Echocardiography revealed thrombi in both the right and left ventricles, severe global hypokinesia, and reduced ejection fraction. The patient was treated with intravenous heparin and showed symptomatic improvement. Diagnostic challenges in RVT were highlighted, emphasizing the limitations of echocardiography in differentiating cardiac masses and the superior diagnostic capabilities of cardiac magnetic resonance imaging (CMR). This case underscores the importance of early diagnosis, individualized management strategies, and the utility of advanced imaging techniques in RVT.