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Published on: June 11, 2019
Left Ventricular Thrombus Formation in Acute Anterior Wall Myocardial Infarction: A Comparison Between Thrombolyzed
Kashif A Hashmi1, Hadi Y Saeed1, Jawad Ahmed1
1Cardiology, Chaudhry Pervaiz Elahi Institute of Cardiology, Multan, PAK.
Insights
Left ventricular thrombus (LVT) is a common complication of acute myocardial infarction (AMI). Prompt treatment, including thrombolysis, significantly reduces LVT formation and associated risks in AMI patients.
Area of Science:
- Cardiology
- Internal Medicine
- Thrombosis Research
Background:
- Left ventricular thrombus (LVT) formation is a significant complication following acute myocardial infarction (AMI).
- Early detection and management of LVT are crucial to prevent thromboembolic events.
- Systemic anticoagulation is a primary intervention for managing LVT.
Purpose of the Study:
- To determine the frequency of LVT in patients with AMI, comparing thrombolyzed and non-thrombolyzed groups.
- To assess the current prevalence of LVT within the local population.
- To identify risk factors associated with LVT formation in AMI patients.
Main Methods:
- A study involving 281 patients (aged 30-65) with anterior wall myocardial infarction (AWMI) was conducted at Chaudhry Pervaiz Elahi Institute of Cardiology, Multan, Pakistan.
- Patients were categorized into thrombolyzed and non-thrombolyzed groups.
- Serial electrocardiography (ECG) and echocardiography were performed until hospital discharge on the third day to diagnose LVT.
Main Results:
- Overall, LVT was detected in 65 out of 281 patients (23.1%).
- LVT was more prevalent in non-thrombolyzed patients (83.1%) compared to thrombolyzed patients (16.9%).
- Significant associations were found between LVT and advanced age, hypertension, family history, and symptom duration.
Conclusions:
- A high incidence of LVT was observed in AWMI patients not receiving thrombolytic therapy.
- LVT formation is strongly linked to comorbidities such as advanced age and hypertension.
- Early hospital presentation and timely thrombolysis are vital for reducing LVT risk, thereby decreasing morbidity and mortality in AMI patients.
Abstract:
Introduction Left ventricular thrombus (LVT) formation is a prominent complication of acute myocardial infarction (AMI). Accurate and prompt detection of the condition is important as it poses a high risk for thromboembolic events that can be arrested by systemic anticoagulation. The purpose of our study was to evaluate the frequency of LVT formation in thrombolyzed and non-thrombolyzed patients with AMI to ascertain the current magnitude of the problem in the local population. Methods The study was conducted at the Chaudhry Pervaiz Elahi Institute of Cardiology in Multan, Pakistan. A total of 281 patients of either gender aged between 30-65 years with anterior wall myocardial infarction (AWMI; both thrombolyzed and non-thrombolyzed) were included in the study. Once they were enrolled in the study, all the relevant baseline investigations were performed. A detailed history was taken and examinations were done; serial ECG and echocardiography were performed till discharge from the hospital on the third day of hospitalization to record the final outcome of the study, i.e., LVT formation. Results The mean age of the patients was 55.54 ± 7.26 years. Overall, LVT formation was noted in 65 cases (23.1%), of which 11 (16.9%) were thrombolyzed patients and 54 (83.1.1%) were non-thrombolyzed. A significant association of LVT was noted with age, hypertension, family history, and duration of symptoms. Conclusion We found a high frequency of LVT formation among patients with AWMI who have not undergone thrombolytic therapy. It was observed that LVT was notably associated with advanced age, hypertension, and other comorbidities. Early presentation to the hospital and thrombolysis reduce the risk of developing LVT, which in turn can reduce morbidity and mortality in such patients.
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