Discussion

The incidence of LV mural thrombi is higher in patients with anterior infarctions than in those with inferior infarctions [1]. Serial transthoracic echocardiography (TTE) study revealed most thrombi develop within the first 2 weeks after myocardial infarction [2]. However, some patients develop a new LV thrombus after discharge, often in association with worsening LV systolic function [3]. In our case, the mural thrombus was not in the myocardial infarction area, but this patient has a dilated LV with severely decreased systolic function and a history of drug abuse. The etiology of the cardiomyopathy may be both ischemic and nonischemic.

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