Case of the Day: Cardiac Apical 4 with contrast

Case Title: Cardiac Case of the Day.

Patient History:

59 y/o male with history of HTN presents with sudden-onset ‘crushing’ chest pain and diaphoresis. Patient found to be in Ventricular tachycardia ~200 bpm with elevated troponin. Cardiac cath demonstrated LAD 90% distal LAD lesion.

Thanks to:

Jess Stout BS, RDCS, ACS, FASE

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IMAGE DESCRIPTION: Apical 4 with contrast

QUESTION: What are the findings on the contrast images provided?

Apical aneurysm with thrombus

No wall motion abnormalities

Severely reduced LVEF

Apical hypokinesis

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IMAGE DESCRIPTION: Apical 4 without contrast

QUESTION: Despite very technically limited images, what do we expect we may see on the echo based on the patient’s history?

Globally reduced LVEF

Apical wall motion abnormality

Aortic dissection

Not enough history provided

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