CAT: cold agglutination test

All patients had no congenital or acquired heart disease with normal sizes of the cardiac chambers and normal left and right ventricular functions during the clinical course. The left ventricular ejection fractions were 62-72%. Right ventricular area changes were 43-47%, In all the cases, the thrombus was located in the middle of the right ventricle, adjacent to the tricuspid chordae tendineae. The thrombus seemed to be surrounded by a net-pocket like structure, formed by the surrounding tissue. Thrombus movement is somewhat limited by multiple attachments, different from the swing movement attaching to a single pedicle, typically seen in myxoma. Morphologically, the thrombus and its attachment to the surrounding tissue can be imagined quite like a neuron and its dendrites. Most of the thrombus has a slightly stronger med-echogenicity, except one case in which it was heteroechoic and hypoechoic. All the thrombi were spherical, with irregular edges and non-compliant. The thrombus is non-capsulated and has no flow within the thrombus. The thrombus in each of the 5 cases were nearly 10-20 mm. No lower limb thrombosis was found in the ultrasound studies of any of the 5 patients. See Table 2 for the echocardiogram results.

Table 2 ultrasonic data of patients