{
  "abstract": "Background: Delayed presentation of anterior ST-segment elevation myocardial infarction (STEMI) increases the risk of thromboembolic and mechanical complications.\n\nCase Summary: We report a 41-year-old man who presented with transient right upper extremity weakness and dysarthria and was found to have electrocardiographic evidence of an old anterior myocardial infarction. He experienced chest pain 3 days earlier without seeking medical attention. Cardiac catheterization revealed thrombotic lesions involving the left anterior descending artery and diagonal bifurcation. Echocardiography demonstrated moderately reduced left ventricular systolic function with a large apical thrombus. Brain magnetic resonance imaging showed a small acute ischemic infarct. He was managed medically with antithrombotics and heart failure therapy. Eight weeks later, regular follow-up imaging revealed severe left ventricular dysfunction, aneurysmal remodeling, and pseudoaneurysm formation, requiring urgent surgical repair.\n\nDiscussion: This case highlights the dynamic progression from thromboembolic to mechanical complications following delayed-presentation STEMI and underscores the importance of early recognition, multimodality imaging, and close follow-up.\n\nTake-Home Messages: Delayed-presentation anterior STEMI may first manifest as acute ischemic stroke because of left ventricular thrombus. Close follow-up and multimodality imaging are essential to detect late mechanical complications such as left ventricular pseudoaneurysm.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Cardiology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon",
    "Division of Cardiothoracic Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon",
    "Division of Anatomic Pathology, Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ibrahim Hasan"
    },
    {
      "affs": [
        0
      ],
      "name": "Nebras Hasan"
    },
    {
      "affs": [
        1
      ],
      "name": "Pierre Sfeir"
    },
    {
      "affs": [
        2
      ],
      "name": "Noura El Sayegh"
    },
    {
      "affs": [
        0
      ],
      "name": "Marwan M. Refaat"
    },
    {
      "affs": [
        0
      ],
      "name": "Ziyad Ghazzal"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2ja9kdx63d6r9.bib",
  "cited_by": 1,
  "doi": "10.1016/j.jaccas.2026.109929",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13698963/",
  "id": "2ja9kdx63d6r9",
  "issns": [
    "2666-0849"
  ],
  "landing_url": "https://doi.org/10.1016/j.jaccas.2026.109929",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Clinical Case"
    ],
    [
      "heading",
      "Ischemic Heart Disease"
    ],
    [
      "lcc",
      "RC666-701"
    ],
    [
      "openalex",
      "2705|Cardiac tumors and thrombi"
    ]
  ],
  "openalex": "W7203834288",
  "pdf_url": null,
  "pmcid": "PMC13698963",
  "pmid": "42622597",
  "published": "2026-08-20",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/2ja9kdx63d6r9.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:39Z",
      "native_id": "PMC13698963",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.jaccas.2026.109929"
    },
    {
      "first_seen": "2026-10-30T13:43:15Z",
      "native_id": "1ee138fa900d4e98ac184f20c5e89634",
      "source": "doaj",
      "url": "https://doi.org/10.1016/j.jaccas.2026.109929"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Cardiac tumors and thrombi",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Ischemic Stroke as the Presenting Feature of Anterior STEMI Complicated by LV Thrombus and Pseudoaneurysm",
  "title_text": "Ischemic Stroke as the Presenting Feature of Anterior STEMI Complicated by LV Thrombus and Pseudoaneurysm",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:43:15Z",
  "url": "https://research.draconitic.com/paper/2ja9kdx63d6r9",
  "venue": "JACC Case Reports",
  "versions": []
}