Successful treatment of a huge thrombus with thrombolytic therapy in a patient with normal left ventricle function and Takayasu arteritis

We report a case of thrombus treated with thrombolytic therapy in a patient with normal cardiac functions and Takayasu arteritis. A 27-year-old man with a history of Takayasu arteritis was admitted to our out-patient clinic with a complaint of both right and left foot pain and weakness. In a Doppler ultrasound examination, a subtotal thrombotic occlusion was found in the bilateral popliteal arteries. A transthoracic echocardiography revealed a left ventricular apical thrombus, although both cardiac functions and heart dimensions were normal. Surgical excision was recommended to avoid further embolization, but this was refused by the patient. We decided to perform thrombolytic treatment. The thrombus in the left ventricle was fully resolved by the third day. Perfusion in both feet also returned to normal.