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An echocardiogram revealed moderate-to-severe global hypokinesis of the LV, ejection fraction (EF) estimated at 30%, a 19×7 mm thrombus in the LV apex and a mildly dilated left atrium with tissue Doppler features of diastolic dysfunction (figures 1 and 2, video 1). Acute decompensated heart failure (ADHF) responded appropriately to .
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