Left ventricular thrombosis and arterial embolism in acute anterior myocardial infarction.
To study left ventricular thrombus (LVT) formation and arterial embolism (AE), 106 consecutive patients with a first acute anterior myocardial infarction (AAMI) underwent two-dimensional echocardiography before discharge. Repeated assessments for detection of AE were performed. Patients were non-randomly allocated to either no heparin, low-dose heparin or high-dose heparin. LVT was found in 25 (26.9%) of 93 patients with technically satisfactory echocardiograms. Left ventricular (LV) wall motion impairment (P = 0.0017) and treatment with either heparin or low-dose heparin (P = 0.0019) were independent predictors of LVT formation. AE, all strokes, occurred in 10 patients (9.4%) and was strongly associated with high age (P = 0.0013). In conclusion, LVT and AE are frequent complications to AAMI. LV wall motion impairment predisposes for LVT and low-dose heparin seems not to prevent these complications.
Kontny
F
F
Medical Department, Aker University Hospital, Oslo, Norway.
Dale
J
J
Nesvold
A
A
Lem
P
P
Søberg
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004452:Echocardiography; D006331:Heart Diseases / Q000209:etiology* / Q000503:physiopathology; D006352:Heart Ventricles; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000209:etiology* / Q000503:physiopathology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D013927:Thrombosis / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology