Left Atrial "Pinball" Thrombus Causing Recurrent Syncope.

A 75-year-old female was admitted due to a syncopal episode. Transesophageal echocardiography demonstrated severe mitral stenosis with a 5 cm, free-floating, left atrial thrombus intermittently obstructing the mitral valve orifice; she underwent thrombus removal and mitral valve replacement.