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Transient left atrial mobile thrombus in acute myocardial infarction--a case report
K Matsuyama1, I Misumi, Y Horio
1Division of Cardiology, Kumamoto University School of Medicine, Japan.
Insights
This study documents the first echocardiographic evidence of a left atrial mobile thrombus following acute myocardial infarction. The thrombus was successfully treated with intravenous urokinase.
Area of Science:
- Cardiology
- Medical Imaging
- Thrombosis Research
Background:
- Acute myocardial infarction (MI) can lead to complex cardiac complications.
- Left atrial thrombus formation is a known risk in certain cardiac conditions.
- Echocardiography is a key diagnostic tool in evaluating cardiac structure and function.
Observation:
- A 50-year-old woman presented with acute inferior myocardial infarction.
- Echocardiography revealed a mobile thrombus within the left atrium.
- This represents the first reported echocardiographic documentation of such a finding post-MI.
Findings:
- Potential contributing factors to thrombus formation included atrial ischemia, left ventricular dysfunction, and diuretic-induced hemoconcentration.
- The left atrial mobile thrombus was successfully lysed using intravenous urokinase.
- No complications were reported during the thrombolytic therapy.
Implications:
- Highlights a rare but significant complication of acute myocardial infarction.
- Underscores the utility of echocardiography in diagnosing intracardiac thrombi.
- Suggests potential therapeutic strategies for managing left atrial thrombi in post-MI patients.
Abstract:
The authors report a fifty-year-old woman with acute inferior myocardial infarction in whom left atrial mobile thrombus was found by echocardiography. They believe this to be the first echocardiographic documentation of such a thrombus after acute myocardial infarction. The combination of the stagnant flow in the left atrium due to atrial ischemia, the low output state due to left ventricular dysfunction, and the hemoconcentric tendency from use of diuretics might have played a role in the present thrombus formation. The thrombus was safely lysed without complication after intravenous urokinase.