Right Heart Failure Caused by Renal Arteriovenous Fistula

tachycardia, it was terminated before his arrival to the hospital. He suffered from anterior wall old myocardial infarction. When he was admitted, he was pulled back to consciousness. His blood examination revealed low oxygen and his chest radiograph showed congestion with cardiac enlargement. The echocardiogram showed akinesis in anterior and apex wall, and detected a mobile thrombus in this area. The size of the thrombus was 28 x 40mm. Anticoagulation therapy with warfarin was started and the thrombus was disappeared after 35 days’ treatment. Then, the patient was re-examined echocardiogram with contrast agent(Levovist). The contrast agent was swirling in akineticwallmotion’s areawhere the thrombushad existed.Wepresumed that the swirling blood flow was the cause of a thrombus formation. The contrast echocardiogram might be a useful tool for the prediction of thrombus formation in heart failure patients.