Abstract
Right ventricular thrombus (RVT) is a rare but clinically significant condition associated with severe complications, such as pulmonary embolism and right heart failure. This case report presents a 68-year-old woman with a history of diabetes, coronary artery disease, and heart failure with reduced ejection fraction (HFrEF), who developed bilateral ventricular thrombi in the context of septic cardiomyopathy secondary to a diabetic foot infection and a urinary tract infection (UTI). Echocardiography revealed thrombi in both the right and left ventricles, severe global hypokinesia, and reduced ejection fraction. The patient was treated with intravenous heparin and showed symptomatic improvement. Diagnostic challenges in RVT were highlighted, emphasizing the limitations of echocardiography in differentiating cardiac masses and the superior diagnostic capabilities of cardiac magnetic resonance imaging (CMR). This case underscores the importance of early diagnosis, individualized management strategies, and the utility of advanced imaging techniques in RVT.