PMC5757095_01
EKG showing ST elevation at II, III, and aVF with reciprocal ST depression at I and aVL.
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Initial electrocardiogram (EKG) showed 1-2 mm ST elevation in inferior leads (II, III, and aVF) with reciprocal ST depression in leads I and aVL (Figure 1).
Coronary angiogram showing an occlusion of the small acute marginal branch (A) of the right coronary artery with slow flow in the posterior descending artery (B).
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There was no other significant CAD (Figure 2).
Transthoracic echocardiogram (TTE) showing a 1.2 x 1.2 cm mobile mass attached to the ventricular aspect of mitral valve and hyperechogenic mitral annulus.
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Subsequent transthoracic echocardiogram (TTE) showed a 1.2 x 1.2 cm mobile mass attached to the base of the posterior mitral valve leaflet on ventricular aspect (Figure 3).
CT scan of the brain without contrast showing an infarct in the left occipital lobe.
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CT scan of the brain without contrast showed an infarct in the left occipital lobe (Figure 4).
Pathology specimens showing a nodule of amorphous debris and fibrinous material in low-power field (a) and histiocytes and multinucleated giant cells in high-power field (b).
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Histologic examination of the mass showed a nodule of amorphous debris and fibrinous material with histiocytes and multinucleated giant cells without organism, consistent with a cardiac CAT (Figure 5).