case_images: PMC8462894_01
case_images: Electrocardiogram showing ST segment elevation in lead V3, V4 and V5 with Q waves in II, III and AVF
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case_images: AVF [Figure 1]. A diagnosis of acute ST elevation MI was made and oral aspirin 325 mg, clopidogrel 300 mg, atorvastatin 80 mg and 3500 units/kg of heparin were administered.
case_images: Left heart cath. showing patent left coronaries
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case_images: Coronary angiography showed chronic total right coronary artery occlusion with collaterals from left and patent left coronary arteries [Figures 2and 3].
case_images: Left heart cath. showing occlusion of RCA with collaterals from left
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case_images: Coronary angiography showed chronic total right coronary artery occlusion with collaterals from left and patent left coronary arteries [Figures 2and 3].
case_images: Left ventriculography shows wall motion abnormalities with mid to apical akinesis and basal hyperkinesis
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case_images: Left ventriculography revealed wall motion abnormalities with mid to apical akinesis and basal hyperkinesis [Figure 4].
case_images: Two-dimensional echocardiogram shows mid-to-apical ballooning of the right and left ventricle
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case_images: Approximately 12 hours later, transthoracic echocardiography revealed left ventricular ejection fraction 25-30%, elevated left ventricular end diastolic pressure and akinesis of left and right ventricle except in the basal region [Figure 5].
case_images: Two-dimensional echocardiography with definity showing LV thrombus
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case_images: A day later, a repeat echocardiogram showed sessile LV thrombus and akinesis of both left and right ventricles except in the basal region [Figure 6].