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A 68-year-old woman who had been resuscitated after cardiac arrest was admitted because of chest pain. The electrocardiogram showed atrial fibrillation and ST-segment elevation in leads II, III, and aVF, findings that indicated a recent inferior myocardial infarct. Transthoracic echocardiography showed hypokinesis of the posterior wall and a free-floating left atrial thrombus. Transesophageal echocardiography showed a dilated left atrium (42 by 63 mm) and severe mitral-valve stenosis, with a mitral-valve area of 0.8 cm2, and confirmed the presence of the free-floating thrombus (Panels A and B), which caused intermittent occlusion of the mitral valve (Panel C and video clip. . . [Full Text of this Article] |