title: [Successful lysis of a mobile left ventricular thrombus by slow infusion of low-dose tissue plasminogen activator].
abstract: There is no consensus on the management of intracardiac mural thrombi. A 59-year-old man underwent echocardiographic examination for right leg pain and pulse deficits in the right lower extremity, which showed severe left ventricular systolic dysfunction and a bell-shaped protruding mobile thrombus in the left ventricular apex. Due to high risk of surgery, 50 mg recombinant tissue-type plasminogen activator (rt-PA) was slowly infused over eight hours. Serial echocardiographic examinations showed a progressive decrease in the size of the thrombus within the first hours of rt-PA infusion, resulting in complete lysis after 24 hours. Low-dose and slow-infusion thrombolytic therapy may be an alternative therapy for left ventricular thrombi when surgery is not feasible.
authors.affiliation: Yüzüncü Yıl Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim Dalı, Van, Turkey. yilmazleman@yahoo.com
authors.forename: Yılmaz
authors.initials: Y
authors.lastname: Güneş
authors.forename: Yemlihan
authors.initials: Y
authors.lastname: Ceylan
authors.forename: Mustafa
authors.initials: M
authors.lastname: Tuncer
mesh_terms: D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006331:Heart Diseases / Q000188:drug therapy*; D006352:Heart Ventricles; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000008:administration & dosage; D015912:Thrombolytic Therapy / Q000379:methods*; D013927:Thrombosis / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D018487:Ventricular Dysfunction, Left / Q000209:etiology*
chemical_list: D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator