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Apical four chamber view showing the thrombus (arrow) in the apex of the left ventricle.
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A 2.5 cm x 1.2 cm apical, protruding, but relatively immobile, left ventricular thrombus (LVT) was detected (Fig. 1).
Apical four chamber view demonstrating the apical aneurysm (A).
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The 120-day scan revealed a frankly large dyskinetic and aneurismal left ventricular apex devoid of obvious thrombus (Fig. 2). The left ventricular segments contiguous with the thrombus were akinetic and remained so after the thrombus resolved, as seen in Figure 2.
Coronary angiogram showing an occluded mid left anterior descending artery.
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Diagnostic catheterization (Fig. 3) was only accessible after one week of admission and it revealed a 30% distal stenosis of the left main coronary artery, as well as significant occlusion of the left anterior descending (LAD) coronary artery in the mid segment with collaterals from the right coronary artery.