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Rapid growth of left ventricular thrombus leading to fatal heart failure in six hours
T Anzai1, Y Asakura, H Yokozuka
1Department of Internal Medicine, Urawa Municipal Hospital, Japan.
Insights
A rapidly growing left ventricular (LV) thrombus caused obstruction and acute LV failure, leading to death despite treatment. This case highlights the severe consequences of thrombus formation post-myocardial infarction.
Area of Science:
- Cardiology
- Pathology
- Immunology
Background:
- Myocardial infarction (MI) can lead to left ventricular (LV) thrombus formation.
- Chronic endocarditis is an inflammation of the heart's inner lining.
- LV thrombi pose a risk of systemic embolism and heart failure.
Observation:
- A patient developed a rapidly growing LV thrombus two months after an anterior MI.
- Echocardiograms revealed the LV thrombus causing obstruction.
- Despite anticoagulant and thrombolytic therapy, the patient experienced acute LV failure.
Findings:
- Histopathology showed a fresh thrombus overlying thickened endocardium.
- Massive T lymphocyte infiltration was observed in the healed infarction area.
- The rapid thrombus growth contributed to the fatal outcome.
Implications:
- This case underscores the potential for rapid LV thrombus growth and obstruction after MI.
- The role of chronic endocarditis and T lymphocyte infiltration in thrombus formation warrants further investigation.
- Aggressive management strategies may be necessary for LV thrombi in post-MI patients with inflammatory conditions.
Abstract:
A left ventricular (LV) thrombus grew rapidly over chronic endocarditis 2 months after anterior myocardial infarction. Echocardiograms demonstrated a rapidly growing LV thrombus an eventual obstruction. Despite anticoagulant/thrombolytic therapy, the patient died of acute LV failure. Histopathologically, a fresh thrombus overlay thickened endocardium with massive T lymphocyte infiltration over healed infarction.