A 62-year-old man has experienced substernal chest pain upon exertion
with increasing frequency over the past 6 months. An electrocardiogram
shows features consistent with ischemic heart disease. He has a total
serum cholesterol of 262 mg/dL. By angiography, there is 75% narrowing
of coronary arteries.
In which of the following locations is a mural
thrombus most likely to occur in this man?
A Left atrium
B Left ventricle
C Right atrium
D Right ventricle
Correct Answe (B)
Rationale: The left ventricle is the major user of oxygen and nutrients
and requires a good blood supply. A complication of ischemic heart
disease with infarction is development of overlying mural thrombus. Such
mural thrombi are likely to result from damage to the left ventricle
from ischemic heart disease, either acutely with an underlying
myocardial infarction, or with a left ventricular aneurysm formed
following resolution of a large myocardial infarction
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