Loading…

Left Ventricular Thrombus Following Acute Myocardial Infarction

AbstractThe incidence of left ventricular (LV) thrombus following acute myocardial infarction has markedly declined in recent decades caused by advancements in reperfusion and antithrombotic therapies. Despite this, embolic events remain the most feared complication of LV thrombus necessitating syst...

Full description

Saved in:
Bibliographic Details
Published in:Journal of the American College of Cardiology 2022-03, Vol.79 (10), p.1010-1022
Main Authors: Camaj, Anton, MD, MS, Fuster, Valentin, MD, PhD, Giustino, Gennaro, MD, Bienstock, Solomon W., MD, Sternheim, David, MD, Mehran, Roxana, MD, Dangas, George D., MD, PhD, Kini, Annapoorna, MD, Sharma, Samin K., MD, Halperin, Jonathan, MD, Dweck, Marc R., MD, PhD, Goldman, Martin E., MD
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:AbstractThe incidence of left ventricular (LV) thrombus following acute myocardial infarction has markedly declined in recent decades caused by advancements in reperfusion and antithrombotic therapies. Despite this, embolic events remain the most feared complication of LV thrombus necessitating systemic anticoagulation. Mechanistically, LV thrombus development depends on Virchow’s triad (ie, endothelial injury from myocardial infarction, blood stasis from LV dysfunction, and hypercoagulability triggered by inflammation, with each of these elements representing potential therapeutic targets). Diagnostic modalities include transthoracic echocardiography with or without ultrasound-enhancing agents and cardiac magnetic resonance. Most LV thrombi develop within the first 2 weeks post–acute myocardial infarction, and the role of surveillance imaging appears limited. Vitamin K antagonists remain the mainstay of therapy because the efficacy of direct oral anticoagulants is less well established. Only meager data support the routine use of prophylactic anticoagulation, even in high-risk patients.
ISSN:0735-1097
DOI:10.1016/j.jacc.2022.01.011