Recent Inferior Myocardial Infarction Complicated with a Right Ventricular Thrombus Detected by Three Cardiac Imaging Modalities

Figures

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  Figure 1.. A: Electrocardiogram shows an abnormal Q wave and inverted T wave in leads III and aVF. B: Three-dimensional transthoracic echocardiography shows a thrombus (16×34 mm; red arrow) in the RV on admission. C: Contrast-enhanced computed tomography shows a thrombus (red arrow) in the RV. D: Coronary angiography shows occlusion in the proximal segment (red arrow) of the right coronary artery (left anterior oblique view). E: Cardiac magnetic resonance imaging (late gadolinium enhancement) shows delayed enhancement of the inferior wall of the LV (white arrow) and almost all parts of the RV (red arrow). RV end-diastolic volume, 121 mL; RV end-systolic volume, 93 mL; RV ejection fraction, 23%. F: Cardiac magnetic resonance imaging (late gadolinium enhancement) shows delayed enhancement of the inferior wall of the LV (white arrow) and a thrombus in the RV (red arrow). RV: right ventricle, LV: left ventricle

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  Figure 2.. A: Stress myocardial perfusion 201thallium scintigraphy (intravenous dipyridamole); left panel: an image immediately after the stress test shows the absence of any 201thallium uptake in the inferior wall; middle panel: an image 4 h after the stress test shows the absence the of redistribution of 201thallium in the inferior wall; right panel: an image 24 h after the stress test shows the partial redistribution of 201thallium in the inferior wall. B: Coronary computed tomography angiography shows recanalization of the right coronary artery. C: Coronary angiography shows recanalization with tiny thrombi (red arrow) in the proximal segment of the right coronary artery (left anterior oblique view). D: Transthoracic echocardiography shows disappearance of the thrombus in the RV at 2-month follow-up. RV: right ventricle, LV: left ventricle