Formation Acute

Left ventricular thrombus formation is a well-de-scribed complication of acute myocardial infarc-tion, and two-dimensional echocardiography is a reliable method for its detection.'.2 The echocar-diographic detection of biventricular thrombi in this setting, however, has not previously been re-p o d. CASE REPORT Clinical Features A previously healthy 33-year-old man developed crushing substernal chest pain. An acute anterior myocardial infarction was diagnosed on the basis of clinical symptoms and pathologic Q waves, ST-T wave changes, and a transient right bundle branch block on the electrocardiogram. Cardiac cathe-terization 5 h after the onset of pain revealed total proximal left anterior descending coronary artery occlusion and a 30 % stenosis of the proximal cir-cumflex artery. Left ventriculography showed globally depressed function, apical and septal dys-kinesis, and severe anterolateral wall hypoki-nesis. Reperfusion of the occluded artery was achieved with balloon angioplasty, and a residual 80 % stenosis and 18 mm Hg translesional gra-dient remained. Intravenous nitroglycerin, lido-caine, and heparin, as well as oral dipyridamole 75 mg TID; aspirin 324 mg TID; and nifedipine 30 mg TID were prescribed. The early hospital course was complicated by hypotension necessitating the use of an intraaor