A case of Cardiomyopathy with Massive LV Thrombus
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Case Report:
A 34-year-old bodybuilder male with a history of prolonged AAS (anabolic androgenic steroids) use presented with a dyspnea and left-hand purple digits. Past medical history revealed a recent cardiac care unit admission for congestive heart failure that was managed medically with digoxin, captopril, carvedilol, diuretics, low-dose Aspirin, and warfarin. The previous TTE showed severe reduced ejection fraction (EF) (30%) with reduced wall thickness and absence of thrombus. The whole septum and apex and anterolateral wall of septum were thin and akinetic with mild mitral regurgitation and preserved right ventricle function. Coronary angiography revealed normal arteries. The patient was discharged in good condition. after 3 months, the patient was admitted with dyspnea and cyanosis of the left hand. On physical examination, he was alert and conscious. The heart rate was 80/min, and blood pressure was 160/100 mmHg. Chest, heart, and abdomen were normal. Jugular venous pressure was normal, and peripheral edema was absent. Radial pulse was present on the right side, but was absent on the left side. Both fundi were normal and visual field defects or nystagmus were not observed. Motor movement and neurologic reflexes were normal in the limbs. Complete blood examination was normal, but erythrocyte sedimentation rate and C-reactive protein were in the upper normal range....