Related Experiment Video
Updated: May 23, 2025
Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
[Diagnostic approach and management of left intraventricular thrombus complicated by unexpected embolism : A case
Thibaut Renotte1, Théophile Tamakloe2, Jean-Louis Mariage3
1Médecine Interne, UCLouvain - Université Catholique de Louvain, Avenue Hippocrate 10, 1200 Bruxelles, Belgique.
Insights
Left ventricular thrombus (LVT), a complication of heart conditions, can lead to dangerous embolisms. This case shows LVT causing splenic infarction years later, emphasizing advanced imaging and new anticoagulant therapies.
Area of Science:
- Cardiology
- Vascular Medicine
Background:
- Left ventricular thrombus (LVT) is a significant complication in ischemic and non-ischemic cardiomyopathies.
- Systemic embolism from LVT poses a high risk of morbidity and mortality.
Purpose of the Study:
- To present a case of LVT leading to splenic infarction and abscessed hematoma.
- To highlight the diagnostic role of advanced medical imaging for LVT.
- To discuss the therapeutic potential of direct oral anticoagulants in managing LVT.
Main Methods:
- Case report of a 73-year-old male with a history of myocardial infarction.
- Utilized advanced medical imaging for diagnosis.
- Reviewed current evidence on LVT management.
Main Results:
- An apical LVT, present for seven years post-myocardial infarction, caused splenic infarction and an abscessed hematoma.
- Advanced imaging was crucial for diagnosing the LVT and its complications.
- Direct oral anticoagulants show emerging therapeutic promise.
Conclusions:
- This case underscores the delayed complications of LVT and the importance of vigilant monitoring.
- Advanced imaging is critical for accurate LVT diagnosis.
- Optimizing LVT management requires ongoing review of therapeutic strategies, including novel anticoagulants.
Abstract:
Left ventricular thrombus (LVT) is a serious complication of both ischemic and non-ischemic cardiomyopathies, with a high risk of morbidity and mortality due to systemic embolism. We present the case of a 73-year-old man with a history of myocardial infarction who subsequently developed an apical thrombus. Seven years after the initial event, this thrombus caused a splenic infarction complicated by an abscessed hematoma. This case underlines the critical role of advanced medical imaging in the diagnosis of LVT and highlights the emerging therapeutic potential of direct oral anticoagulants. It also highlights the challenges of diagnosing and managing LVT and the importance of reviewing the latest evidence to refine and optimize therapeutic strategies.
