Ping pong ball in the hefty heart: a case report.

We describe here a very unusual case of a large free floating left atrial thrombus due to critical mitral stenosis detected by incidental echocardiography, in whom peculiar symptoms and complications of ball thrombus were absent. The patent's only symptom was mild dyspnoea attributed to smoking. She had no syncope or arrhythmia induced embolic event. Owing to non-availability of cardiothoracic facility, she was given anticoagulant therapy which resulted in intracerebral haemorrhage and death.