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 3 Transthoracic echocardiogram obtained during the patient’s Emergency Department presentation in April 2022 for recurrent stroke. The image reveals a large, immobile thrombus firmly attached to the apical wall of the left ventricle, measuring 17.5×16.4 mm. The thrombus size had increased since the previous scan, indicating progression of the left ventricular thrombus. The thrombus is clearly marked by the red arrow.

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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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