Biventricular Thrombus Complicating Cardiogenic Shock: A Point-of-care Ultrasound-guided Diagnosis and Management

We report a rare case of biventricular thrombus presenting as cardiogenic shock with decompensated heart failure and abdominal pain in a previously healthy individual. Diagnosis was expedited using point-of-care ultrasound (POCUS), which revealed right heart strain, biventricular thrombi, and features of volume overload. The patient was managed conservatively with anticoagulation, diuretics, and supportive care and eventually transitioned to long-term oral anticoagulation. This case highlights the diagnostic value of bedside ultrasound (POCUS) in first-contact acute care and the current lack of clear guidance for managing decompensated heart failure with simultaneous left and right ventricular thrombi.