Left ventricular (LV) thrombus is one of myocardial infarction (MI) complications and if the thrombus is mobile and protruding, there is a high risk of embolization. It is exceptionally rare that the presenting serious symptom of acute MI is severe leg pain. We report here a rare case of a 36-year-old Caucasian male patient with unrecognized MI complicated by LV thrombus. His initial visit to the physician was due to sudden onset of severe left leg pain as a consequence of thromboembolism. Medical examination revealed occluded left femoral commune artery and femoral superficial artery, subacute MI and apical LV thrombus, which were treated accordingly. On follow-up, 2 months after hospital discharge, patient affirmed that he has been walking for approximately 3 km every day, without leg cramps or angina. Early recognition of MI, even when presented with atypical symptoms in young individuals and its prompt treatment is important to improve survival, as well as to reduce thrombotic events.

Aortopulmonary window in adults without signs of heart failure or pulmonary hypertension is exceptionally rare. We report here a case of a 27-year-old Caucasian male patient who presented with ventricular tachycardia and loud laterosternal systolic murmur due to a 9 mm aortopulmonary septal defect type 1, diagnosed for the first time. Echocardiography examination also revealed moderate pulmonary artery regurgitation. Pulmonary artery regurgitation may have served as the knight in shining armor in this extremely rare asymptomatic adult patient with aortopulmonary window, since a large amount of blood that enters the pulmonary trunk from the aorta redirects toward the right ventricle. Ventricular tachycardia may be the sole clinical presentation in an adult patient with aortopulmonary window and moderate pulmonary window.