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A 57-year-old woman was evaluated for chronic progressive effort intolerance and dyspnoea on exertion. On clinical examination she was found to be in congestive heart failure. Transthoracic echocardiography revealed four-chamber dilation, severe global hypokinesis and severe systolic dysfunction. Three non-pedunculated thrombi of 3.1, 2.5, and 1.8 cm2 were seen in the apical area of the dilated left ventricle (figure). All the thrombi were of glistening appearance, which suggested that they had been organised.
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