Simultaneous left and right ventricular apical thrombi after occlusion of the wrapped left anterior descending artery.

Left ventricular (LV) thrombus formation is a well-known complication of acute myocardial infarction (AMI) and is reported to occur in 5-8% of patients who have anterior or apical myocardial infarction. However, right ventricular (RV) thrombus has not previously been reported after AMI. We describe a 54-year-old woman who presented with an ST-elevation myocardial infarction due to occlusion of the distal left anterior descending artery, which wrapped around the apex and led to simultaneous LV and RV apical thrombi. <Learning objective: This case emphasizes the following: (1) in patients who have a long left anterior descending artery (LAD) that wraps around the apex, even distal LAD occlusion can cause a large infarct area including the apex, inferior wall, and right ventricular apex, as well as serious complications such as cardiac arrest and left ventricular and right ventricular (RV) thrombus. (2) Cardiac magnetic resonance imaging is useful for detecting apical thrombus especially in the RV.>.