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[Cross-sectional echocardiographic features of mobile left ventricular thrombi (author's transl)]
Insights
Mobile left ventricular thrombi occur in 3% of myocardial infarction patients, detected by echocardiography. These thrombi may increase the risk of systemic embolization and sudden death.
Area of Science:
- Cardiology
- Diagnostic Imaging
Background:
- Assessing mobile left ventricular thrombi (MLVT) frequency and characteristics is crucial.
- Understanding the relationship between MLVT and systemic embolization is important for patient outcomes.
Observation:
- Cross-sectional echocardiography identified MLVT in 5 (3%) of 154 myocardial infarction patients.
- All patients with MLVT had anterior wall myocardial infarction patterns.
- MLVT appeared as rotating abnormal echoes from the infarcted left ventricular wall.
Findings:
- One patient with MLVT experienced cerebral embolism; two others had sudden death, potentially linked to MLVT.
- In patients without MLVT, systemic embolization occurred in only 2% (3/149).
- Thrombus size varied among affected individuals.
Implications:
- Cross-sectional echocardiography is effective for detecting MLVT.
- MLVT following myocardial infarction may be a significant risk factor for cerebral or peripheral emboli.
- Further investigation into sudden death causes in MLVT patients is warranted.
Abstract:
To assess the frequency, characteristics and relation to systemic embolization of mobile left ventricular thrombi, 154 patients with myocardial infarction were studied by cross-sectional echocardiography. In 5 (3%) a mobile left ventricular thrombus was detected. The electrocardiograms of all these patients showed anterior wall myocardial infarction pattern. One had cerebral embolism and two died suddenly. The cause of sudden death was not known, but it may be related to the presence of mobile left ventricular thrombi. In the remaining 149 patients, only 3 (2%) had cerebral or peripheral embolism. Mobile left ventricular thrombi was shown as rotating abnormal echoes arising from the left ventricular wall (infarcted area) by cross-sectional echocardiography. The size of thrombus was variable in each case. We concluded that cross-sectional echocardiography was useful in detecting mobile left ventricular thrombi, and that mobile left ventricular thrombi may be related to cerebral or peripheral emboli secondary to myocardial infraction.