Infection of left ventricular thrombus in a patient with silent myocardial infarction — a unique complication

A 72-year-old male was admitted to hospital with exertional dyspnoea of recent onset. Echocardiography showed a left ventricle which was severely hypokinetic on the anteroseptal and anterior wall with an akinetic inferior wall and apex. A string of globular masses was seen to be floating in the left ventricle, attached to the septum near the apex. Coronary arteriography showed severe two-vessel disease. Urgent surgery revealed degenerated thrombus in the left ventricle containing green pus. The infected thrombus was attached to an area of septal infarction. The pus-filled thrombus was removed and by-pass grafting was effected. No infective organism was identfled.