Dilated cardiomyopathy and thrombo-embolism.
The purpose of this study was to investigate the incidence, outcome and prevention of thrombo-embolism in children with dilated cardiomyopathy. From 130 patients with dilated cardiomyopathy, 17 (14%) showed evidence of thrombo-embolism. Seven had initial cardiac thrombus, 7 exhibited initial embolus and in 3 thrombo-embolism was only diagnosed at autopsy. All 17 patients showed seriously impaired systolic function of the left ventricle with fractional shortening (FS) of 10 +/- 3%, range 5%-17%, as compared to those without thrombo-embolism with FS of 17% +/- 6%, range 5%-26% (P < 0.0001). Seven patients were treated with oral anticoagulants once thrombo-embolism had been diagnosed; one of them experienced a further embolic event as opposed to three out of four patients not treated with anticoagulants.


CONCLUSIONS
All children with dilated cardiomyopathy and fractional shortening below 20% should be treated with prophylactic anticoagulative agents.
Günthard
J
J
University Children's Hospital, Barno, Switzerland.
Stocker
F
F
Bolz
D
D
Jäggi
E
E
Ghisla
R
R
Oberhänsli
I
I
Wyler
F
F
D000293:Adolescent; D000925:Anticoagulants / Q000627:therapeutic use; D002311:Cardiomyopathy, Dilated / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D015994:Incidence; D007223:Infant; D012189:Retrospective Studies; D012459:Salicylates / Q000627:therapeutic use; D020156:Salicylic Acid; D013557:Switzerland; D013923:Thromboembolism / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome; D014463:Ultrasonography
D000925:Anticoagulants; D012459:Salicylates; D020156:Salicylic Acid