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Left ventricular thrombus formation after first anterior wall acute myocardial infarction

G A Lamas1, D E Vaughan, M A Pfeffer

  • 1Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts 02115.

The American Journal of Cardiology
|July 1, 1988
PubMed

Insights

Left ventricular (LV) thrombus formation after anterior myocardial infarction is linked to wall motion abnormalities and altered ventricular shape, not coronary artery disease extent. Ejection fraction, shape change, and LV end-diastolic pressure are key predictors.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Clinical Medicine

Background:

  • Left ventricular (LV) thrombus is a potential complication following acute myocardial infarction (AMI).
  • Understanding the predictors of LV thrombus is crucial for risk stratification and management in anterior AMI patients.

Purpose of the Study:

  • To define the left ventricular and coronary artery characteristics associated with LV thrombus in patients with recent anterior acute myocardial infarction.
  • To identify independent correlates of LV thrombus formation post-anterior AMI.

Main Methods:

  • Retrospective analysis of 77 patients with recent anterior acute myocardial infarction.
  • Assessment of coronary artery disease extent, LV wall motion abnormalities (akinesia and dyskinesia), and ventricular shape changes.
  • Measurement of LV diastolic and systolic volumes, ejection fraction, and LV end-diastolic pressure.
  • Stepwise discriminant analysis to identify independent correlates of LV thrombus.

Main Results:

  • LV thrombus was present in 46% of patients (35 of 77).
  • Thrombus presence correlated significantly with increasing wall motion abnormality (p < 0.001) and ventricular shape change (p < 0.001).
  • Patients with LV thrombi exhibited larger LV diastolic and systolic volumes.
  • Independent correlates of LV thrombus included ejection fraction, extent of early shape change, and LV end-diastolic pressure.

Conclusions:

  • LV thrombus formation after anterior AMI is strongly associated with impaired LV function and altered ventricular geometry.
  • Coronary artery disease extent is not a primary determinant of LV thrombus in this patient group.
  • Ejection fraction, ventricular shape, and LV end-diastolic pressure are important factors for predicting LV thrombus post-myocardial infarction.

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