Prognostic significance and natural history of left ventricular thrombi in patients with acute anterior myocardial infarction: a two-dimensional echocardiographic study.

Abstract

Fifty-eight patients with transmural anterior myocardial infarction were prospectively studied with serial two-dimensional Circulation 72, No. 4, 774-780, 1985. TWO-DIMENSIONAL ECHOCARDIOGRAPHY has recently demonstrated that left ventricular thrombi are common in patients with acute anterior myocardial infarction.1-5 However, the clinical implications and prognostic significance of detection of thrombi during acute myocardial infarction, the incidence of systemic embolization, and the possible occurrence of spontaneous regression of left ventricular thrombus have not yet been investigated in prospective studies conducted

Cardiac and Extracardiac Abnormalities Detected by Cardiac Magnetic Resonance in a Post-Myocardial Infarction Cohort

“…Studies from the pre- and early reperfusion eras reported that LV thrombus occurred in 15–56% of anterior AMIs, while contemporary studies suggest a lower overall incidence in general (∼4%), skewed towards the anterior AMI subgroup within which the incidence approaches 10% [19,20,21,22,23,24]. We report an overall incidence of LV thrombus in AMI patients with LVSD of 15%.…”

“…More than half of LV thrombi undetected on initial TTE remained undetected on repeat TTE. While there has been debate as to the actual incidence of embolic events in cases of LV thrombus after AMI, its detection is of relevance as it is associated with poorer LV function, adverse remodeling, and greater mortality [23,24,25,26]. Our policy was to anticoagulate formally all patients with identified LV thrombus; in all cases the thrombus had resolved by the 3-month follow-up scan, and in no case was there evidence of an embolic event during the 6-month follow-up.…”

Risk factors for stroke and use of echocardiography in diagnosis: a review

“…However, this has to be weighed against the risk of embolisation. If the source of embolism is identified, the risk of death increases considerably to 0-38% (11,12). Cost effectiveness of TEE has been confirmed in cases with heart diseases(13).…”

“…Other causes are atherosclerotic cerebrovascular disease such as carotid and intracranial vascular diseases which are responsible for about 20% of cases, penetrating arterial disease (lacunar) account for 25%, cryptogenic stroke accounting for about 30% and the remaining 5% are attributed to other causes such as hypercoagulant state, vasculitis, carotid dissection and vasospasm (6)(7)(8)(9)(10)(11)(12)(13). Consequently, the search for cardiac source of emboli is an important issue, which should be undertaken.…”

Differentiation Between Fresh and Old Left Ventricular Thrombi by Deformation Imaging

“…It is commonly acknowledgd that LV thrombus formation is the major source of embolic stroke after ST-elevated myocardial infarction, 1,26 Data on embolic risk in patients with LV thrombus varies. [2][3][4][5]11,[27][28][29] However, most embolic events occur in the first 4 months after myocardial infarction. 4,12,29 Thus, the intrinsic properties of the thrombus change with aging: the older thrombus is more fixed to the LV wall and less fragile because of its collagen-rich organization.…”