Acute Ischemic Stroke and Rapid Resolution of a Large Left Ventricular Thrombus With Low-Molecular-Weight Heparin: A Case Report.

We present the case of a 62-year-old male who presented with an acute ischemic stroke and was subsequently diagnosed with a large mobile left ventricular (LV) thrombus. Although surgical intervention was initially considered, the cardiothoracic team opted for conservative management. The patient was managed conservatively with aspirin and later therapeutic low-molecular-weight heparin (LMWH) due to the LV thrombus. Notably, follow-up echocardiography after two weeks revealed complete resolution of the LV thrombus, an outcome that highlights the efficacy of LMWH and the potential for rapid resolution without surgical intervention. The patient experienced further complications, including a new cerebellar infarct and venous thromboembolism, prompting investigation for underlying hypercoagulable states such as lupus antibodies. This case underscores the critical importance of early investigation for secondary causes of ischemic stroke and demonstrates the significant therapeutic potential of LMWH in achieving rapid LV thrombus resolution, thereby preventing the need for more invasive procedures.