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  Indian J Med Microbiol
 

Figure 7: A 36-year-old female is a case of chronic ITP on treatment. She has been experiencing dyspnea on exertion for 1 month. Echocardiography revealed a large mass lesion in the LV cavity, causing obliteration of the LV with moderate tricuspid regurgitation, mild mitral regurgitation, and severe pulmonary arterial hypertension. CMR was performed for the evaluation of cardiac mass (asterisk). (a) T1W double inversion recovery shows that the mass (asterisk) is isointense to the myocardium. (b) 2C cine shows near-complete obliteration of LV cavity by the mass. (c) 4C cine shows near-complete obliteration of the LV cavity by the mass. (d) T2W triple inversion recovery shows that the mass appears isointense to the myocardium. (e) 2C LGE images with routine TI ~230 ms show no appreciable enhancement. Note the nulled myocardium appearing dark. (f) 4C LGE image with TI of 600 ms shows no appreciable enhancement. The thrombus persists to appear dark, whereas the myocardium appears brighter. Compare this with the nulled myocardium in e. The patient underwent an emergency mass excision. Histopathological examination was suggestive of an organized thrombus. Revisiting the CMR images, the mass shows typical features of a thrombus. Final diagnosis: LV thrombus in chronic ITP on treatment.[17] 2C: Two-chamber, 4C: Four-chamber, CMR: Cardiac magnetic resonance imaging, ITP: Idiopathic thrombocytopenic purpura, LGE: Late gadolinium enhancement, LV: Left ventricle, MI: Myocardial infarction, TI: Time to inversion, W: Weighted

Figure 7: A 36-year-old female is a case of chronic ITP on treatment. She has been experiencing dyspnea on exertion for 1 month. Echocardiography revealed a large mass lesion in the LV cavity, causing obliteration of the LV with moderate tricuspid regurgitation, mild mitral regurgitation, and severe pulmonary arterial hypertension. CMR was performed for the evaluation of cardiac mass (asterisk). (a) T1W double inversion recovery shows that the mass (asterisk) is isointense to the myocardium. (b) 2C cine shows near-complete obliteration of LV cavity by the mass. (c) 4C cine shows near-complete obliteration of the LV cavity by the mass. (d) T2W triple inversion recovery shows that the mass appears isointense to the myocardium. (e) 2C LGE images with routine TI ~230 ms show no appreciable enhancement. Note the nulled myocardium appearing dark. (f) 4C LGE image with TI of 600 ms shows no appreciable enhancement. The thrombus persists to appear dark, whereas the myocardium appears brighter. Compare this with the nulled myocardium in e. The patient underwent an emergency mass excision. Histopathological examination was suggestive of an organized thrombus. Revisiting the CMR images, the mass shows typical features of a thrombus. Final diagnosis: LV thrombus in chronic ITP on treatment.<sup>[17]</sup> 2C: Two-chamber, 4C: Four-chamber, CMR: Cardiac magnetic resonance imaging, ITP: Idiopathic thrombocytopenic purpura, LGE: Late gadolinium enhancement, LV: Left ventricle, MI: Myocardial infarction, TI: Time to inversion, W: Weighted