Recurrent Stroke and Progression of Left Ventricular Thrombus During Apixaban Therapy in a Patient with Severe Ischemic Cardiomyopathy: A Case Report

Alaa Babonji; Fatima Ahmad Algethmi; Basmah Salman Almutairi; Afnan Alsulami; Adel F. Al-Mrzouki

doi:10.12659/AJCR.949883

08 December 2025 : Case report Saudi Arabia

Recurrent Stroke and Progression of Left Ventricular Thrombus During Apixaban Therapy in a Patient with Severe Ischemic Cardiomyopathy: A Case Report

Unusual clinical course, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Unexpected drug reaction

Alaa Babonji

^{ABCDEF 1*}, Fatima Ahmad Algethmi^{BDEF 2}, Basmah Salman Almutairi^{BDEF 3}, Afnan Alsulami^{BDEF 4}, Adel F. Al-Mrzouki

^{BDEF 5,6,7}

DOI: 10.12659/AJCR.949883

Am J Case Rep 2025; 26:e949883

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Figure 1 Initial transthoracic echocardiogram performed in October 2021 demonstrates a large, immobile thrombus (indicated by the red arrow) firmly adherent to the apical wall of the left ventricle. The thrombus measured approximately 17.5×9.9 mm and appeared well-defined with no signs of mobility, suggesting chronicity and posing a potential risk for embolic events.

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Recurrent Stroke and Progression of Left Ventricular Thrombus During Apixaban Therapy in a Patient with Severe Ischemic Cardiomyopathy: A Case Report

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