title: Multimodality cardiac imaging of a left ventricular thrombus: a case report.
abstract: BACKGROUND
  Left ventricular thrombus (LVT) formation occasionally complicates patient recovery post myocardial infarction, conveying a significant risk of systemic embolism. Accordingly, thrombus detection and subsequent anticoagulation is imperative in order to minimize patient morbidity and mortality. Transthoracic echocardiography (TTE) is the imaging modality most widely used to screen for thrombus formation despite its suboptimal sensitivity and specificity.
  
  
  METHODS
  This report describes the discordant imaging findings of a LVT in a 56 year old Caucasian male with an anterior ST elevation myocardial infarction. Left ventriculography revealed a filling defect, suggestive of a potential left ventricular (LV) thrombus, which could not be confirmed by TTE. Cardiac magnetic resonance imaging (MRI) demonstrated evidence of a full thickness scar involving the mid to distal anterior wall and apical regions, with confirmation of a small LV apical thrombus.
  
  
  CONCLUSIONS
  This case illustrates the limitations of TTE when used as a tool to screen for thrombus formation. It highlights the importance of multimodality cardiac imaging for the detection of post myocardial infarction (MI) complications, in the context of a high clinical suspicion.
authors.affiliation: Institute of Cardiovascular Sciences, St. Boniface Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada. vgoyal@sbrc.ca.
authors.forename: Vineet
authors.initials: V
authors.lastname: Goyal
authors.affiliation: Institute of Cardiovascular Sciences, St. Boniface Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada. bewsh@myumanitoba.ca.
authors.forename: Hilary
authors.initials: H
authors.lastname: Bews
authors.affiliation: Section of Cardiology, Department of Internal Medicine, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. nshaikh@sbgh.mb.ca.
authors.forename: Nasir
authors.initials: N
authors.lastname: Shaikh
authors.affiliation: Section of Cardiology, Department of Internal Medicine, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. fhussain017@gmail.com.
authors.forename: Farrukh
authors.initials: F
authors.lastname: Hussain
authors.affiliation: Institute of Cardiovascular Sciences, St. Boniface Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada. djassal@sbgh.mb.ca.|Section of Cardiology, Department of Internal Medicine, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. djassal@sbgh.mb.ca.|Department of Radiology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. djassal@sbgh.mb.ca.|Section of Cardiology, Department of Internal Medicine, College of Medicine, Faculty of Health Sciences, University of Manitoba, Rm Y3531, Bergen Cardiac Care Centre, St. Boniface General Hospital, 409 Tache Avenue, Winnipeg, Manitoba, R2H 2A6, Canada. djassal@sbgh.mb.ca.
authors.forename: Davinder S
authors.initials: DS
authors.lastname: Jassal
mesh_terms: D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D015635:Radionuclide Ventriculography; D013927:Thrombosis / Q000000981:diagnostic imaging*; D014463:Ultrasonography