Always check the apex, even if you don’t see any regional wall motion abnormalities!
This was an LV apical thrombus resolved after anticoagulation.
LV thrombus can occur within 24 h after a myocardial infarction.
One study performing serial echocardiographic studies showed that about 90% of thrombi are formed at a maximum of 2 weeks after the index event.
However, some patients develop a new LV thrombus after discharge, often in association with worsening LV systolic function.
Spontaneous or anticoagulant induced resolution is relatively common in LV thrombus formation after a myocardial infarction.
Thrombus seems to disappear more often in patients with apical akinesia than those with apical aneurysm or dyskinesia.