Successful treatment of a huge thrombus with thrombolytic therapy in a patient with normal left ventricle function and Takayasu arteritis

Şeker, Taner; Baykan, Ahmet Oytun; Börekçi, Abdürrezzak; Gür, Mustafa; Çaylı, Murat

doi:10.5543/tkda.2014.60687

Cited by 4 publications

(1 citation statement)

References 10 publications

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“…There are only a few anecdotal reports on the management of giant, huge, massive, or obliterating thrombus, including treatment with DOAC, fibrinolytic therapy, and surgical resection. [116][117][118][119][120] In unusual circumstances, thrombus size may affect diastolic ventricular volume or obstruct either mitral inflow or aortic outflow. There are insufficient data to preferentially recommend any one approach to large or massive LV thrombi, and these rare scenarios are best addressed with a multidisciplinary approach to therapeutic intervention.…”

Section: Management Of Massive LV Thrombusmentioning

confidence: 99%

Management of Patients at Risk for and With Left Ventricular Thrombus: A Scientific Statement From the American Heart Association

Levine¹,

McEvoy²,

Fang³

et al. 2022

Circulation

112

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Despite the many advances in cardiovascular medicine, decisions concerning the diagnosis, prevention, and treatment of left ventricular (LV) thrombus often remain challenging. There are only limited organizational guideline recommendations with regard to LV thrombus. Furthermore, management issues in current practice are increasingly complex, including concerns about adding oral anticoagulant therapy to dual antiplatelet therapy, the availability of direct oral anticoagulants as a potential alternative option to traditional vitamin K antagonists, and the use of diagnostic modalities such as cardiac magnetic resonance imaging, which has greater sensitivity for LV thrombus detection than echocardiography. Therefore, this American Heart Association scientific statement was commissioned with the goals of addressing 8 key clinical management questions related to LV thrombus, including the prevention and treatment after myocardial infarction, prevention and treatment in dilated cardiomyopathy, management of mural (laminated) thrombus, imaging of LV thrombus, direct oral anticoagulants as an alternative to warfarin, treatments other than oral anticoagulants for LV thrombus (eg, dual antiplatelet therapy, fibrinolysis, surgical excision), and the approach to persistent LV thrombus despite anticoagulation therapy. Practical management suggestions in the form of text, tables, and flow diagrams based on careful and critical review of actual study data as formulated by this multidisciplinary writing committee are given.

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Section: Management Of Massive LV Thrombusmentioning

confidence: 99%

Management of Patients at Risk for and With Left Ventricular Thrombus: A Scientific Statement From the American Heart Association

Levine¹,

McEvoy²,

Fang³

et al. 2022

Circulation

112

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Cardiac involvement in primary systemic vasculitis and potential drug therapies to reduce cardiovascular risk

Misra

Shenoy

2016

Rheumatol Int

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Cardiac involvement is common in primary systemic vasculitides and may be due to direct effect of the disease on the heart or due to therapy. We shall review involvement of the heart in the various forms of primary systemic vasculitis. Among anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV), eosinophilic granulomatosis with polyangiitis most commonly involves the heart. Involvement of the heart confers poorer prognosis in AAV, which is also complicated by increased risk of cardiovascular events. Kawasaki's disease (KD) is the most common form of medium-vessel vasculitis to affect the heart, with coronary artery aneurysms being the most common manifestation. These predispose patients with KD to develop premature ischemic heart disease. Takayasu's arteritis is the most common large-vessel vasculitis to involve the heart and can result in aortic incompetence, myocarditis, or coronary heart disease. Involvement of the heart in Behcet's disease is usually in the form of intracardiac mass lesions, thrombosis, or endomyocardial fibrosis. Drugs used in the treatment of systemic vasculitis influence the risk of developing cardiovascular events. Corticosteroid therapy has been shown to increase the risk of myocardial infarction, whereas methotrexate, azathioprine, mycophenolate mofetil, rituximab, and anti-tumor necrosis alpha agents favorably modulate the risk of cardiovascular events, predominantly by dampening systemic inflammation. Awareness of cardiac involvement in vasculitis and accelerated cardiovascular risk in these patients should help clinicians to maximize the modulation of modifiable risk factors for heart disease in these individuals.

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Patients with Left Ventricular Thrombus Despite Normal Systolic Function

Svendsen

Pauley

Falk

et al. 2021

The American Journal of the Medical Sciences

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Successful treatment of a huge thrombus with thrombolytic therapy in a patient with normal left ventricle function and Takayasu arteritis

Cited by 4 publications

References 10 publications

Management of Patients at Risk for and With Left Ventricular Thrombus: A Scientific Statement From the American Heart Association

Management of Patients at Risk for and With Left Ventricular Thrombus: A Scientific Statement From the American Heart Association

Cardiac involvement in primary systemic vasculitis and potential drug therapies to reduce cardiovascular risk

Patients with Left Ventricular Thrombus Despite Normal Systolic Function

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