Three days after a large anterior myocardial infarction, transthoracic echocardiography shows apical akinesia but cannot distinguish trabeculation fro...

Question

Three days after a large anterior myocardial infarction, transthoracic echocardiography shows apical akinesia but cannot distinguish trabeculation from a laminated left-ventricular thrombus. The result would change anticoagulation. Which test best resolves the uncertainty?

Accepted Answer

Obtain cardiac magnetic resonance imaging with thrombus-sensitive sequences

Answer

Repeat a non-contrast chest CT after six weeks

Answer

Use exercise echocardiography to provoke thrombus movement

Answer

Use ambulatory ECG monitoring to quantify embolic risk

Answer

Perform invasive coronary angiography to visualise the ventricular apex

Infective Endocarditis-Initial Steps — MRCP Part 1 MCQ

Three days after a large anterior myocardial infarction, transthoracic echocardiography shows apical akinesia but cannot distinguish trabeculation from a laminated left-ventricular thrombus. The result would change anticoagulation. Which test best resolves the uncertainty?