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Left ventricular thrombi in children with dilated cardiomyopathy
1Department of Pediatrics, National Taiwan University Hospital, Taipei, ROC.
Insights
Pediatric patients with dilated cardiomyopathy face a risk of left ventricular (LV) thrombi and systemic embolization. Lower ejection fraction may increase this risk, leading to poor outcomes even with treatment.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Research
- Thrombosis
Background:
- Dilated cardiomyopathy in children can lead to serious complications.
- Left ventricular thrombi (LV thrombi) are a potential complication.
- Understanding the characteristics of LV thrombi is crucial for risk assessment.
Purpose of the Study:
- To define the nature and course of left ventricular thrombi in pediatric patients.
- To identify potential risk factors and outcomes associated with LV thrombi in this population.
Main Methods:
- Retrospective chart and echocardiographic record review.
- Analysis of 32 pediatric patients diagnosed with dilated cardiomyopathy between 1986 and 1991.
- Identification of LV thrombi using echocardiographic evidence.
Main Results:
- Five patients with dilated cardiomyopathy were found to have LV thrombi.
- Three patients with LV thrombi experienced systemic embolization and died, despite anticoagulant therapy.
- Patients with LV thrombi showed a trend towards lower ejection fraction.
- Nonprotruding thrombus morphology was observed in patients with systemic embolization.
Conclusions:
- Children with dilated cardiomyopathy are at risk for developing LV thrombi and subsequent systemic embolization.
- Lower ejection fraction may be associated with an increased risk of LV thrombi and embolization.
- Early identification and management strategies for LV thrombi in pediatric dilated cardiomyopathy are warranted.
Abstract:
To define the nature and course of left ventricular (LV) thrombi in pediatric patients, the charts and echocardiographic records of 32 pediatric patients with dilated cardiomyopathy from 1986 to 1991 were retrospectively reviewed. Five patients who were identified according to echocardiographic evidence of LV thrombi fulfilled the criteria of dilated cardiomyopathy. Systemic embolization occurred in three patients with LV thrombi who invariably died despite anticoagulant treatment. Although it was not statistically significant, patients with LV thrombi tended to have a lower ejection fraction compared to patients without LV thrombi. The morphology of LV thrombi in patients with systemic embolization showed nonprotruding features. Thus, children with dilated cardiomyopathy are at risk of developing LV thrombi and systemic embolization. Although it was not possible to identify the risk factors, the risk of developing LV thrombi and systemic embolization may be higher in patients with lower ejection fraction of the left ventricle.