Heart Attack’s Hidden Danger

A 70-year-old with diabetes has epigastric pain. ECG and troponin suggest an MI. What complication is revealed by a filling defect on ventriculography?

Mural thrombus


A 70-year-old woman with diabetes mellitus presented to the emergency department with a 3-day history of epigastric pain and vomiting. An electrocardiogram showed normal sinus rhythm with pathologic Q waves and T-wave inversions in the anterior leads. A high-sensitivity troponin test showed a troponin level of 686 ng per liter (reference value, <11). What finding is shown in these images from the patient's left ventriculography and transthoracic echocardiography?

What is the most likely diagnosis?

Mural thrombus
Rhabdomyoma
Ruptured papillary muscle
Sarcoma
Vegetation

Anticoagulation, Echocardiography, Left Anterior Descending Artery, Mural thrombus, Myocardial Infarction

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