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The present image shows an echocardiogram depicting a large left ventricular (LV) apical aneurysm (20 cm2) with spontaneous contrast (figure 1; cine images are provided as videos 1 and 2) in a patient with hypertrophic cardiomyopathy (HCM) whose first presentation was in the seventh decade of her life. The patient presented with a history of dyspnoea and was in periarrest ventricular tachycardia (VT) in the emergency department. Five DC shocks were unsuccessful and she eventually …
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