Left ventricular mural thrombi complicating acute myocardial infarction. Long-term follow-up with serial echocardiography.
To determine the clinical significance of left ventricular thrombi, we used two-dimensional echocardiography to study 261 patients with acute transmural myocardial infarction. Mural thrombi were found in 46 patients. This complication occurred in 34% (44 of 130) of anterior wall infarctions but in only 1.5% (2 of 131) of inferior wall infarctions. An apical wall motion abnormality was present in all patients with thrombus. Severe depression of left ventricular function was not a prerequisite for thrombus formation: the mean left ventricular ejection fraction was 37 +/- 1.5%. Forty-three patients with left ventricular thrombi were followed for a mean duration of 15 months with serial echocardiography. None of the 25 patients who received anticoagulation treatment had an embolic event. Embolization occurred in 7 of 18 patients who had not received anticoagulation treatment. All embolic events occurred within 4 months of infarction. Although anticoagulation treatment appeared to provide protection against embolic events, the prevalence of left ventricular thrombi on follow-up echocardiographic study was essentially the same whether or not this treatment was used.
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D009202:Cardiomyopathies / Q000150:complications / Q000188:drug therapy / Q000209:etiology*; D004452:Echocardiography / Q000379:methods; D004617:Embolism / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D013927:Thrombosis / Q000150:complications / Q000188:drug therapy / Q000209:etiology*
D000925:Anticoagulants