A case of rheumatic heart disease, mitral stenosis, large left atrium, and chronic atrial fibrillation is reported and discussed. This patient was shown, by means of two-dimensional echocardiography, to have a massive left atrial thrombus, and after the initiation of anticoagulation with warfarin, complete resolution of the clot was seen in less than two months. The use of two-dimen sional echocardiography was valuable in the follow-up of this patient, and it is suggested that further prospective studies are necessary for better understand ing the natural history of left atrial thrombus.
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