Lysis of a left ventricular thrombus with recombinant tissue plasminogen activator.
A 23-year-old woman with peripartum cardiomyopathy presented with a 2.1 x 2.5-cm pedunculated, mobile, left ventricular thrombus and evidence of systemic embolization. Due to the patient's poor left ventricular function, thrombectomy was not a viable option. Treatment with high-dose IV heparin was initially utilized but was unsuccessful as the thrombus appeared to enlarge on echocardiography. An accelerated weight-adjusted dose of recombinant tissue plasminogen activator (rt-PA) successfully lysed the thrombus without evidence of embolization. Although rt-PA has been used for primary lysis of high-risk ventricular thrombi, this is the first documentation of successful lysis of a left ventricular thrombus in a patient with peripartum cardiomyopathy.
Rester
B T
BT
Department of Internal Medicine, Divisions of Cardiology and Pulmonology/Critical Care, University of Mississippi Medical Center, Jackson, MS 39216-4505, USA.
Warnock
J L
JL
Patel
P B
PB
McMullan
M R
MR
Skelton
T N
TN
Collop
N A
NA
D000328:Adult; D009202:Cardiomyopathies / Q000150:complications; D005260:Female; D006331:Heart Diseases / Q000628:therapy*; D006801:Humans; D011644:Puerperal Disorders / Q000628:therapy; D011994:Recombinant Proteins / Q000627:therapeutic use; D013927:Thrombosis / Q000628:therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator