Abstract
BACKGROUND: Massive biventricular thrombi associated with myocarditis are rare and pose significant management challenges. CASE PRESENTATION: A 24-year-old male from a plateau region presented with dyspnea, chest pain, and cerebral infarction/hemorrhage. Imaging revealed giant biventricular thrombi (left: 81 × 62 × 59 mm; right: 59 × 16 mm) and LVEF of 25%. MANAGEMENT: Multidisciplinary therapy included anticoagulation and GDMT. OUTCOMES: Complete thrombus resolution occurred by 10 weeks, with improved cardiac function (LVEF 48%) and no recurrent embolism. CONCLUSION: Drug therapy may be effective for massive biventricular thrombi in myocarditis.