PMC9270166_01
Electrocardiogram on a day of admission with sinus rhythm, left axis deviation, T wave inversion in aVL, and V3 and multiple premature ventricular contraction.
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Electrocardiogram (EKG) showed sinus rhythm, left axis deviation, T wave inversion in aVL, and V1, multiple premature ventricular complexes, and left anterior fascicular block (Figure 1).
CTA showing evidence of right atrial and right ventricular apical thrombus (red arrows).
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Chest computed tomography angiography (CTA) was negative for pulmonary embolism or aortic dissection; however, there was evidence of right atrial and right ventricular apical thrombus (Figure 2).
Trend of absolute eosinophil count from 5/22/19 to 7/16/2020 and start date of dexamethasone 10 mg daily.
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CMR. (a) Double inversion recovery (IR) T2-weighted axial imaging showing increased signal intensity of myocardium in the appendix of left and right ventricles consistent with myocardial edema (red arrows). (b) Tripe IR T1-weighted fat saturation axial image showing again signal intensity in the myocardium (green arrows). (c) Balanced steady state free precession (bSSFP) horizontal long axis still frame showing increase signaling with severe right atrial enlargement and possible thrombus (blue arrows).
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T2-weighted images showed increased signal intensity at the left ventricular and right ventricular apex, consistent with myocardial edema (MRI Figure 4(a)). T1-weighted images showed increased signal intensity in the same area (MRI Figure 4(b)). Balanced steady free precession images showed mildly reduced left ventricular systolic function with calculated EF of 44% with probable right ventricular apical and right atrial thrombus (MRI Figures 4(c)).