title: Incidence and clinical significance of left ventricular thrombus in tako-tsubo cardiomyopathy assessed with echocardiography.
abstract: BACKGROUND
  Left ventricular (LV) thrombus is a known complication of tako-tsubo cardiomyopathy (TC). However, current literature almost exclusively consists of isolated case reports. The aim of this study was to determine the incidence and clinical significance of LV thrombus formation in TC.
  
  
  RESULTS
  Over a 33-month period 52 patients with TC were assembled into a database at our institution. A retrospective database search was performed to identify patients with LV thrombus among these patients. LV thrombus, by echocardiography, was discovered in four patients[(8%); 95% confidence interval 3-19%]. Thrombus was present at the time of diagnosis in three patients. In one patient thrombus was absent initially and developed later. The LV apex was the site of thrombus formation in two patients, but the true apex was spared in the other two. All four patients had elevated serum levels of C-reactive protein (CRP). Two patients also had thrombocytosis. Treatment with low molecular weight heparin (LMWH) led to resolution of thrombus in all cases.
  
  
  CONCLUSIONS
  Our findings suggest that LV thrombus is a noteworthy complication in TC. It can occur both at initial presentation or at anytime later during the disease course. Elevated CRP levels and thrombocytosis may indicate a higher risk of thrombus formation.
authors.affiliation: I. Medizinische Klinik, Universitätsklinikum Mannheim. 68167 Mannheim, Germany. dariush.haghi@med.ma.uni-heidelberg.de
authors.forename: D
authors.initials: D
authors.lastname: Haghi
authors.forename: T
authors.initials: T
authors.lastname: Papavassiliu
authors.forename: F
authors.initials: F
authors.lastname: Heggemann
authors.forename: J J
authors.initials: JJ
authors.lastname: Kaden
authors.forename: M
authors.initials: M
authors.lastname: Borggrefe
authors.forename: T
authors.initials: T
authors.lastname: Suselbeck
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D004452:Echocardiography; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D012189:Retrospective Studies; D054549:Takotsubo Cardiomyopathy / Q000150:complications* / Q000000981:diagnostic imaging; D013927:Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000000981:diagnostic imaging
chemical_list: D000925:Anticoagulants; D006493:Heparin