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Clinical features of intracardiac thrombosis based on echocardiographic observation
Insights
Intracardiac thrombi in heart disease patients often form due to blood stasis. Anticoagulant therapy
Area of Science:
- Cardiology
- Echocardiography
- Thrombosis Research
Background:
- Intracardiac thrombi are a significant complication in patients with mitral valve disease and myocardial infarction.
- Understanding the formation, characteristics, and clinical implications of these thrombi is crucial for patient management.
Purpose of the Study:
- To investigate the clinical conditions underlying intracardiac thrombi.
- To determine the relationship between intracardiac thrombi and systemic embolism.
- To analyze thrombus growth and the impact of anticoagulant therapy on thrombus size.
Main Methods:
- Two-dimensional echocardiography was utilized in a cohort of 818 patients with mitral valve disease and 1000 patients with myocardial infarction.
- Echocardiographic parameters were assessed to identify underlying conditions and thrombus characteristics.
Main Results:
- Common predisposing factors included atrial fibrillation, enlarged left atrium, mitral stenosis, apical asynergy, and low ejection fraction, with blood stasis identified as a major factor.
- Systemic embolism occurred more frequently in patients with intracardiac thrombi.
- Intracardiac thrombi exhibited dynamic behavior, including growth, spontaneous size reduction, and detachment, forming ball thrombi.
- The efficacy of anticoagulant therapy in thrombus regression was dependent on the thrombus age.
Conclusions:
- Blood stasis is a primary driver for intracardiac thrombus formation.
- Intracardiac thrombi are dynamic entities with implications for systemic embolism.
- Anticoagulant therapy's effectiveness in reducing thrombus size is age-dependent.
Abstract:
The nature of intracardiac thrombi were studied, which were the clinical underlying conditions, relation to systemic embolism, growth of thrombus and effect of anticoagulant therapy on the size of the thrombi, in 818 patients with mitral valve disease and 1000 patients with myocardial infarction by two-dimensional echocardiography. (1) Common underlying conditions were atrial fibrillation, enlarged left atrial cavity and predominance of mitral stenosis in cases with left atrial thrombi, and apical asynergy and low ejection fraction in cases with ventricular thrombi. The blood stasis should be the major factor in the formation of intracardiac thrombi. In a condition of blood stasis, dynamic intracavitary echoes which may represent erythrocyte aggregation were observed. (2) The incidence of systemic embolism in patients with thrombi was higher than that in patients without thrombi in cardiac disease. (3) The intracardiac thrombi were living. They grew and/or reduced their size spontaneously and sometimes became detached from the cardiac wall in the form of ball thrombi. (4) The effect of anticoagulant therapy on the regression of thrombi depends on its age.