Massive left ventricular mural thrombosis with consumption coagulopathy in congestive heart failure.

THE SYNDROME OF consumption coagulopathy occurs in association with a wide variety of underlying illnesses. In general, resolution of the coagulopathy accompanies successful treatment of the primary disorder. If the underlying pathological process is not clinically apparent, evidence of consumption coagulopathy may be a clue leading to diagnosis and appropriate therapy. Such conditions may include complications of pregnancy (for example, amnionitis or abruptio placentae), arterial aneurysms, giant hemangiomata and malignant lesions.' The association of consumption coagulopathy with congestive heart failure is not widely recognized. We report a case of massive left ventricular mural thrombosis and consumption coagulopathy in the setting of congestive cardiomyopathy, and discuss the possibility that the coagulation defects that may occur in heart failure can contribute to the development of mural thrombi.