 The quality improvement project successfully improved the diagnosis and management of left ventricular thrombus at a tertiary cardiology center. The team increased the use of direct oral anticoagulants DOACs from 25% to 70% and shortened the time from diagnosis to repeat imaging to within three to six months as recommended by guidelines. Additionally, they published trust-wide guidelines on the management of LV thrombus with recommendation supporting the use of DOACs and appropriate follow-up imaging.