PMC8060067_01
Electrocardiogram on patient presentation to the emergency department showed normal sinus rhythm with no acute S-ST changes.
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Electrocardiogram (EKG) showed normal sinus rhythm with no acute ST changes (Figure 1).
Multiple angiographic views of the distal left main filling defect involving the bifurcation extending into the left anterior descending (LAD) and proximal left circumflex arteries.
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Angiography showed a 90% filling defect involving the distal left main coronary artery (LMCA) with an extension to the proximal left anterior descending (LAD) and proximal left circumflex (LCx; Figure 2).
Transesophageal echocardiogram view showing the atrial septal defect.
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Transesophageal echo (TEE) revealed an atrial septal defect (ASD) measuring 0.9 x 0.6 cm and was confirmed using echo colored Doppler and an agitated saline bubble study (Figure 3). There was no left atrial appendage thrombus (LAA), valvular vegetations, or left ventricular thrombus.
Multiple angiographic views showing patent left main coronary, left anterior descending, and left circumflex arteries.
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A repeat coronary angiogram done after 72 hours of medical management showed complete resolution of the thrombus without any residual stenosis (Figure 4).