This case report describes a patient with aortic and mitral valvular disease who had a massive left atrial thrombus. The left atrial thrombus produced a disappearance of signs of mitral stenosis and a reversed pan diastolic mitral valve gradient. This gradient occurred in the absence of any diastolic mitral insufficiency and may have been due to artifactual lowering of the left atrial pressure by an organized left atrial clot.
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