1. DR. MOHAMMED AL-MARWALH DR. ABEER ALSALABA DR. AREEJ AL-JABALI DR.RWA'A YASSEN DR.ABDULAZIZ AONALLAH DCMP complicated by LV thrombus

2. Case presentation: DCMP complicated by LV thrombus 32 male patient, not known to have DM nor HTN, ex-smoker but he is Qat chewer, pt gave history of major stress 2 months ago there is no hx. Of cardiovascular diseases in his family patient was presented to the ER complaining of atypical chest pain burning in nature associated with lower limbs edema which was progressive in course and abdominal distention

3. DCMP complicated by LV thrombus on Examination patient was conscious oriented looks ill not pale, not cyanosed, not jaundiced there was mild lower limb edema C.V.S=S1+S2+0 Chest= mild basal crepitation on RT side., Abdomen= soft

4. DCMP complicated by LV thrombus investigations CBC,RFT,LFT were within normal cardiac enzymes normal ECG showed= sinus rhythm, Lt. axis deviation Lt. arterial enlargement, poor R wave progression In anterior leads LVH with strain pattern by voltage criteria

5. DCMP complicated by LV thrombus ECHO=

6. DCMP complicated by LV thrombus ECHO=

7. DCMP complicated by LV thrombus ECHO= global hypocontractility moderate LV impairment very large mural fresh mobile Thrombus occupying more than 60% of the left ventricle cavity moderate MR, Mild TR

8. DCMP complicated by LV thrombus Diagnosis: DCMP complicated by LV thrombus. The plan of management of this patient were anticoagulant and anti heart failure treatment

9. DCMP complicated by LV thrombus AFTER MANAGEMENT : Picture of the thrombus after the management

10. AFTER MANAGEMENT :

13. Dr.Mohammed ALMarwala