Giant Left Ventricular Thrombus in a Patient with Acute Ischemic Stroke: A Case Report and Minireview

Fan, Ye; Silverstein, Burton V.; Khuddus, Matheen; Bray, Christopher; Lee, Arthur C.

doi:10.1155/2018/3714742

Cited by 4 publications

(3 citation statements)

References 15 publications

(13 reference statements)

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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

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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

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“…Intracardiac thrombus formation is a potentially severe complication related to cardiac conditions such as ischemic and non-ischemic cardiomyopathies (with or without manifest heart failure), valvular diseases and atrial fibrillation [3,4]. In the pathophysiology of LVT development the elements of Virchow's triad play the main role: (1) wall motion abnormalities causing slow flow conditions and blood stasis, (2) the presence of local and systemic proinflammatory factors provoking endocardial lesions and (3) hypercoagulability [5,6].…”

Section: Discussionmentioning

confidence: 99%

Extensive Left Ventricular Thrombosis with Concomitant Pulmonary Embolism

Magdás

Podoleanu

Frigy

2021

Clinics and Practice

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A 57-year-old non-obese female patient with a history of heavy smoking, chronic obstructive pulmonary disease and hypertension was admitted to the hospital as an emergency for acute hemoptysis and signs of congestive heart failure. To assess the source of hemoptysis, computed tomography (CT) pulmonary angiography was performed, which confirmed a bilateral pulmonary embolism of the apical branches. The routinely performed transthoracic echocardiography (TTE) revealed an enlarged left ventricle with severely reduced ejection fraction (EF = 25%) due to global hypokinesia and multiple, mobile, echogenic masses. To increase the diagnostic accuracy, real-time three-dimensional (Live 3D) imaging of the masses was added which described multiple left ventricular (LV) thrombi. Successful resolution of intraventricular thrombi was noticed after treatment with oral anticoagulant therapy (acenocumarol), despite the lack of regular INR control.

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“…Echocardiography is important to evaluate cardiac function and scan for complications in patients who had prior MI. Patients who suffered from embolic complications, such as cerebrovascular events, should also be scanned to highlight the source of embolism [5,6].…”

Section: Discussionmentioning

confidence: 99%

Giant mobile left ventricular apical thrombus following silent infarction in a young patient: A case report

İnanç¹,

Alıc²,

Karakuş³

2020

Journal of Surgery and Medicine

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Today, percutaneous coronary treatment and anticoagulation therapies are commonly used worldwide, which is why the incidence of reported left ventricular (LV) thrombus decreased. Despite modern methods, we still encounter thromboembolic complications resulting in morbidity and mortality in a large number of patients, especially after silent infarctions. Because of high embolism risk, early detection of LV thrombus is crucial. We present the rare and interesting case of a 34-year-old patient diagnosed with a large, fragmented, very mobile left ventricular apical thrombus after silent myocardial infarction due to total occlusion of left anterior descending coronary artery.

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Giant Left Ventricular Thrombus in a Patient with Acute Ischemic Stroke: A Case Report and Minireview

Cited by 4 publications

References 15 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

Extensive Left Ventricular Thrombosis with Concomitant Pulmonary Embolism

Giant mobile left ventricular apical thrombus following silent infarction in a young patient: A case report

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