Ruptured plaque or embolised thrombus

A 38 year old woman with acute chest pain was admitted to the hospital. Positive troponins and electrocardiographic signs of anterior wall myocardial infarction during atrial fibrillation were found. Echocardiography (panel below) showed hypokinesia of the anterior wall and severe mitral stenosis (arrowhead; LV, left ventricle; SC, spontaneous contrast). Coronary angiography …