Maise Fredgart

Highlights • Left atrial size is an important predictor of cardiovascular disease and mortality. • An area measurement from non-contrast CT is a simple estimate of left atrial size. • Left atrial area is associated with risk of atrial fibrillation, heart failure and mortality. • Left atrial area could improve risk assessment beyond CAC score in non-contrast CT.

We describe a case with severe heart failure and moderate aortic stenosis. Due to previous atrial fibrillation and ischaemic heart disease, this patient was treated with both dabigatran and clopidogrel. Despite this, a large mural thrombus was found on echocardiography. The treatment was altered to warfarin, but the thrombus did not resolve during the next eight months. Guidelines for the use of anticoagulant treatment in left ventricular thrombus are needed.