A 78-year-old woman underwent surgical intervention for severe atrial functional mitral regurgitation and left ventricular apical aneurysm secondary to apical hypertrophic cardiomyopathy. Apical hypertrophic cardiomyopathy can cause atrial fibrillation and atrial functional mitral regurgitation. Left ventricular apical aneurysms can cause fatal arrhythmias, which may require surgical intervention.

A 59-year-old man with a long smoking history presented with sudden back pain. Frank's sign was noticed in his bilateral ears, and computed tomography revealed Stanford type A acute aortic dissection. If young patients have Frank's sign, attention should be paid to atherosclerotic disease including aortic disease.

We report a case of a 63-year-old man without a history of atrial fibrillation or mitral valve disease who was admitted to our hospital. Echocardiography revealed a large left atrial mass attached to the atrial septum. We suspected the mass to be a myxoma, but it turned out to be a large thrombus after the surgery. Left atrial thrombus without mitral valve disease or atrial fibrillation is rare. Although the degree of urgency varies based on the case, early surgical resection is recommended for a large left atrial thrombus to prevent embolism.