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[Echocardiographic detection and follow up of left ventricular thrombosis following myocardial infarct]
1Jósa András Kórház-Rendelöintézet Nyíregyháza, III. sz. Belgyógyászati Osztály/Kardiológia.
Insights
Left ventricular thrombi are a frequent complication of myocardial infarction, particularly anterior types. Anticoagulant therapy, monitored by echocardiography, is crucial for thrombus resolution and preventing embolic events.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Left ventricular thrombi (LVT) are a known complication of myocardial infarction (MI).
- Anterior MI is associated with a higher risk of LVT formation.
Purpose of the Study:
- To investigate the incidence, characteristics, and outcomes of LVT in patients with MI.
- To evaluate the efficacy of anticoagulant therapy in managing LVT and preventing embolic events.
Main Methods:
- Retrospective analysis of 914 patients with MI over 3 years.
- Echocardiography used for thrombus detection, characterization, and follow-up.
- Assessment of anticoagulant therapy's impact on thrombus resolution and embolic events.
Main Results:
- LVT detected in 8% of MI patients (74/914), more common in males.
- Apical location was most frequent (61 cases).
- Anticoagulant therapy led to thrombus resolution in 23/53 restudied patients; 10 cerebral embolic events occurred.
Conclusions:
- Thrombosis is a frequent complication of anterior MI, posing a risk for embolic events.
- Echocardiography-guided anticoagulant therapy is effective in resolving LVT and reducing embolism risk.
Abstract:
914 patients with myocardial infarction have been examined during the last 3 years. Left ventricular thrombi were found in 74 patients (8%), (58 male and 16 female, median age 57.3 years). Thrombi were found in 37 cases, oval protruding in 28 cases, pedicled or multiple in 9 cases. Thrombus was most frequently located to the apex (61 cases), while in 8 patients localization was anteroseptal, in 4 patients anterolateral and in 1 patient inferior. 36 patients had also ventricular aneurysm of which 23 were at the apex and 13 at the anterior wall. After anticoagulant therapy the patients were controlled by echocardiography. In 23 out of the 53 patients that were restudied the thrombus had resolved, in 8 patients thrombus has decreased in size and in 22 patients there was no change in thrombus size. Embolism has occurred in 13 cases of which 10 were cerebral embolism. During the follow-up period (mean 12.8 months) six patients died. On the basis of their study the authors conclude that thrombosis is a frequent complication of anterior myocardial infarction and may lead to embolic events, so anticoagulant therapy controlled by echocardiography is needed, because of it's efficacy in the resolution of thrombus and eliminating the risk of embolism.