A previously fit 22 year old man was struck in the chest by a concrete block dropped through the windscreen of his car while he was driving on the motorway. He suffered extensive chest wall trauma And lung contusion, which subsequently Precipitated acute respiratory distress. On admission ECG showed right bundle Branch block and left axis deviation. Three days later QRS duration was nor- Mal but there was anterior St segment Elevation and subsequent T wave change. There was a large rise in creatine kinase, And echocardiography revealed septal and Apical hyokinesis as well as a mobile mass Attached to the left side of the interven- Tricular septum, which had the echogenic Texture of myocardium.
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