Effect of early systemic thrombolytic therapy on left ventricular mural thrombus formation in acute anterior myocardial infarction.
To determine the effects of intravenous thrombolytic therapy on the development of left ventricular (LV) thrombi after anterior acute myocardial infarction (MI), 22 consecutive patients were prospectively studied with radionuclide ventriculography and serial 2-dimensional echocardiography: 12 patients who presented within 3 hours after MI received intravenous streptokinase (STK) followed by intravenous heparin as thrombolytic treatment and 10 patients who were seen later than 3 hours after the onset of symptoms served as controls. The LV ejection fraction was less than 0.40 in 3 of 12 patients who received STK and in 7 of 10 who did not (control subjects) (p less than 0.05). Apical dyssynergy was observed in all 12 patients treated with STK and in 9 of 10 control subjects. LV thrombi were presented within 36 hours of MI in 5 control subjects. Thrombi were detected by 2-dimensional echocardiography in 7 of 10 control subjects and in 1 of 12 patients who received intravenous STK (p less than 0.005). Early thrombolytic therapy with intravenous STK and heparin appears to significantly reduce the frequency of LV thrombus formation despite persistence of apical dyssynergy.
D000328:Adult; D000368:Aged; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D011446:Prospective Studies; D011877:Radionuclide Imaging; D013300:Streptokinase / Q000627:therapeutic use*; D013318:Stroke Volume / Q000187:drug effects
D006493:Heparin; D013300:Streptokinase