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Related Concept Videos

Venous Thrombosis I: Introduction01:30

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Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
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Pulmonary Embolism I: Introduction01:29

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Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
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Mitral Regurgitation I: Introduction01:20

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Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
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Ischemic Heart Disease: Overview01:17

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Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
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Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

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The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
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Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

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Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
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Related Experiment Video

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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
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Left ventricular thrombosis: new perspectives on an old problem.

Mauro Massussi1, Andrea Scotti1, Gregory Y H Lip2

  • 1Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua Medical School, Via Giustiniani 2, 35128 Padua, Italy.

European Heart Journal. Cardiovascular Pharmacotherapy
|June 23, 2020
PubMed
Summary

Left ventricular thrombosis (LVT) poses a significant risk for systemic thromboembolism. Current anticoagulation therapies carry bleeding risks, and more research is needed on direct oral anticoagulants for LVT treatment.

Keywords:
Acute myocardial infarctionAnticoagulation therapyLeft ventricular thrombosis

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Area of Science:

  • Cardiology
  • Hematology
  • Thrombosis Research

Background:

  • Left ventricular thrombosis (LVT) is a critical risk factor for systemic thromboembolism.
  • LVT can complicate both acute and chronic phases of ischemic heart disease post-myocardial infarction and non-ischemic cardiomyopathies.
  • Thrombus formation involves Virchow's triad: blood stasis, prothrombotic state, and tissue injury.

Purpose of the Study:

  • To review the current understanding of left ventricular thrombosis.
  • To discuss the challenges in optimal treatment strategies for LVT.
  • To evaluate the role of anticoagulation in managing LVT and associated risks.

Main Methods:

  • Literature review of pathophysiology and treatment of left ventricular thrombosis.
  • Analysis of current anticoagulation strategies, including heparin and vitamin K antagonists.
  • Examination of emerging data on direct oral anticoagulants for LVT.

Main Results:

  • Advances in imaging have increased LVT detection rates.
  • Conventional anticoagulation reduces embolic risk but increases bleeding complications.
  • Limited data suggests potential safety and efficacy of direct oral anticoagulants for LVT.

Conclusions:

  • Optimal treatment strategies for LVT remain uncertain in clinical practice.
  • Further evidence is required to support the use of direct oral anticoagulants for LVT.
  • Balancing embolic risk reduction with bleeding complications is crucial in LVT management.