A 66-year-old man collapsed at home with chest pain. He was found by paramedics to be in ventricular fibrillation leading to a cardiac arrest. A post-resuscitation electrocardiogram showed sinus rhythm and inferolateral ST-segment elevation. On arrival at our department he had an emergency invasive coronary angiogram which showed an occluded left circumflex artery, confirming myocardial infarction (MI). We opened the artery using a balloon, and following recanalisation, we identified a substantial filling defect indicative of a large thrombus (figure).
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