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Heparin treatment and resolution of left ventricular thrombosis
V Palazzuoli1, S Mondillo, N D'Aprile
1Istituto di Patologia Speciale Medica, Università degli Studi di Siena, Italy.
Insights
Heparin therapy effectively dissolved an intraventricular thrombus in a patient with myocardial infarction. This suggests heparin can be a viable alternative to immediate surgery for such cases.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Intraventricular thrombi can form following myocardial infarction, posing a risk of systemic embolism.
- Management often involves anticoagulation or surgical intervention.
Observation:
- A 70-year-old male presented with transient disorientation and ECG findings of inferior myocardial infarction.
- Echocardiography revealed a 1.5 cm hyperechogenic mass in the apex, consistent with an organized thrombus.
Findings:
- Treatment with calcium-heparin (12,500 IU every 8 hours) for 20 days led to complete resolution of the intraventricular thrombus.
- Serial echocardiography confirmed the thrombus disappearance.
Implications:
- This case supports the thrombolytic efficacy of heparin in resolving intraventricular thrombi.
- Heparin therapy may allow for postponement of immediate surgical removal of intraventricular thrombi.
- Non-invasive management with heparin offers a potential alternative to surgery in select patients.
Abstract:
In a 70-year-old man admitted to our hospital because of repeated episodes of transient disorientation, an ECG showed a recent inferior myocardial infarction. A two-dimensional echocardiography detected hypo-akinesia in the apex region, where a hyperechogenic oval and pedunculated mass with a maximum diameter of 1.5 cm, attributable to an organized thrombus, was located. After 20 days of therapy with calcium-heparin at a dose of 12,500 IU every 8 h, a two-dimensional echocardiography showed the complete disappearance of the mass. This and other recent reports confirm the thrombolytic activity of the drug and the possibility of postponing the immediate surgical removal of intraventricular thrombi in favour of heparin treatment.