The appearance of a small thrombus in the pulmonary vein indicates the existence of a smaller pulmonary vein

Stroke is a leading cause of serious long-term disability and the third-leading cause of death [1]. Acute ischemic stroke accounts for approximately 70% of all strokes, and cardiac embolism accounts for approximately 15% of embolic strokes. Atrial fibrillation (AF), which is responsible for 10% of all ischemic strokes and half of all cardioembolic strokes, increases the risk of stroke by 4to 5-fold in nonrheumatic patients. The left atrial appendage (LAA) is the most common location in which a thrombus forms in the left atrium (LA). Transesophageal echocardiography is a routine clinical procedure that is frequently used prior to cardioversion to detect an LA thrombus. Pulmonary vein thrombosis is a potentially life threatening condition that can lead to thromboembolic stroke, but the occurrence of this type of thrombosis is believed to be rare and often goes undiagnosed and untreated. The primary causes of pulmonary vein thrombi formation are thought to be lung surgery [2], lung transplantation [3,4], and increased expansion of lung cancer [5]. The signs and symptoms of this condition are generally atypical, thus resulting in its underdiagnosis. Since 2012, I have publishedmany cases of pulmonary vein thromboses in elderly patients who present without traditional clinical conditions. In 2014, I reported that 35 (61%) of 57 elderly patients with chest pain had a pulmonary vein thrombus [6], indicating that pulmonary vein thromboses are more common in elderly populations. In 2015, I reported that a small thrombus in the visible small pulmonary