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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
06:29

Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques

Published on: June 11, 2019

[Ventricular thrombi in the chronic infarct stage: echocardiographic findings, clinical aspects, relations to

D Kneissl, P Bubenheimer, H Roskamm

    Zeitschrift Fur Kardiologie
    |November 1, 1985
    PubMed

    Insights

    Left ventricular thrombi are common after myocardial infarction, especially with anterior wall damage. Effective anticoagulant therapy promotes thrombus regression and prevents recurrence in post-infarction patients.

    Area of Science:

    • Cardiology
    • Medical Imaging
    • Thrombosis Research

    Context:

    • Left ventricular mural thrombi are a recognized complication in the chronic phase of myocardial infarction.
    • Prevalence and characteristics of these thrombi vary based on infarct location and left ventricular function.

    Purpose:

    • To investigate the prevalence, associated factors, and clinical outcomes of left ventricular mural thrombi in patients with chronic myocardial infarction.
    • To evaluate the impact of anticoagulant therapy on thrombus regression and recurrence.

    Summary:

    • Left ventricular mural thrombi were detected in 10% of 1,383 patients with chronic myocardial infarction using 2D-echocardiography.
    • Thrombi were more frequent in anterior or combined anterior-posterior infarcts and left ventricular aneurysms, often associated with extensive myocardial damage and severe left ventricular dysfunction.
    • Systemic embolization occurred significantly more often in patients with thrombi (7.9%) compared to those without (0.7%).
    • At diagnosis, 90% of patients with thrombi were not on effective anticoagulant therapy. Follow-up showed thrombus regression in 93% of effectively anticoagulated patients, while persisting thrombi were seen in only 20% of those inadequately treated.
    • Discontinuation of anticoagulant therapy poses a high risk for thrombus recurrence.

    Impact:

    • This study highlights the significant association between left ventricular thrombi and adverse events like systemic embolization in myocardial infarction survivors.
    • Findings underscore the critical role of timely diagnosis via 2D-echocardiography and effective anticoagulant management in improving outcomes and preventing complications.
    • The results emphasize the need for vigilant monitoring and sustained anticoagulant therapy in patients with post-myocardial infarction left ventricular thrombi.

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