Case 256 Medical history A 41-year-old male patient from Janaúba (MG) attended a medical visit to follow up on heart disease, being also megaesophagus carrier. He is currently complaining of palpitations, muscle weakness, fatigue to small / medium / great efforts and nocturnal paroxysmal dyspnea. For investigation, Holter (showing isolated ventricular extrasystoles and non-sustained ventricular tachycardia), exercise test (without clinical evidence of myocardial ischemia), chest X-ray (that was normal) in relation to the underlying disease, echocardiogram (ECHO) and ECG , were done and attached below. Image 1: Two-dimensional transthoracic echocardiogram (ECO) in parasternal window, short axis transverse section, four (A) and two chambers (B).Image 2: 12-lead electrocardiogram. Question:Considering the clinical history and the exams performed, what is the diagnosis of the visualized image of ECHO and the most probable underlying disease? Thrombus - Acute myocardial infarction Tumor - Myxoma Thrombus - Chagas Disease Hypertrophic injury - Hypertensive heart failure Time is Up! Time's up