Figure 2.

68-year-old male with a history of ischemic cardiomyopathy and an episode of cardiogenic shock. The echocardiography demonstrated a reduced left ventricular ejection fraction of 25%. Delayed enhancement imaging was performed utilizing an SSFP sequence, 10 minutes following the administration of 20 ml of Gd-based contrast agent. (A) Short axis view demonstrates transmural delayed enhancement of the septum (white arrowhead) and the anterior wall (black arrowhead). (B) Four-chamber view demonstrates transmural delayed enhancement of the septum (white arrowhead) and the apex (arrow). There is also delayed enhancement in the papillary muscle (black arrowhead). (C) Two-chamber view obtained from a cine- SSFP sequence demonstrates thinning of the anterior wall and the apex post infarct. In addition there is aneurysmal dilatation of the apex and a thrombus adjacent to the apicoinferior wall (arrow). These are findings in the vascular territory of the left anterior descending coronary artery.