# Mobile Intracardiac Mass after Inguinal Hernia Repair: An Unresolved Treatment Dilemma

## TL;DR

An 81-year-old man with a large mobile heart thrombus was successfully treated with anticoagulation, highlighting diagnostic and treatment challenges.

## Contribution

The case demonstrates successful anticoagulation treatment for a rare right heart thrombus without surgical intervention.

## Key findings

- Anticoagulation alone successfully treated a large mobile right heart thrombus in an elderly patient.
- Transthoracic echocardiogram was crucial for diagnosing the thrombus and guiding treatment decisions.

## Abstract

Right heart thrombi (RHT) are rare but well-described entity in literature. Their isolation has been considered as confirmatory for the diagnosis of venous thromboembolism (VTE). Even though their isolation aids the diagnosis, physicians are faced with a difficult management dilemma giving the paucity of data to support any treatment decision. We present a case of RHT in an 81-year-old man who presented to hospital with a large mobile right heart thrombus in transit seen on transthoracic echocardiogram (TTE). He was successfully treated with anticoagulation alone. This case highlights the importance of TTE in establishing the diagnosis and describes the interplay of factors influencing treatment decision.