Resolution of left ventricular thrombus with lepirudin after failed treatment with heparin

A 49-year-old man was admitted with high-risk left ventricular thrombosis and systemic embolization. Prompt and complete resolution of the thrombus was achieved under intravenous lepirudin administration but not under full-dose heparin treatment. Medical physicians, including emergency medicine phys...

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Bibliographic Details
Published in:The American journal of emergency medicine 2012-07, Vol.30 (6), p.1015.e3-1015.e5
Main Authors: Margulescu, Andrei D., MD, Fraser, Alan G., MD
Format: Article
Language:English
Subjects:
Anticoagulants
Blood clots
Cardiology
Cardiomyopathy
Case reports
Coronary Thrombosis - diagnostic imaging
Coronary Thrombosis - drug therapy
Drug dosages
Echocardiography
Ejection fraction
Embolization
Emergency
Emergency medical care
Fibrinolytic Agents - therapeutic use
Heart failure
Heart surgery
Heart Ventricles - diagnostic imaging
Heparin - therapeutic use
Hirudins
Humans
Ischemia
Male
Medical personnel
Middle Aged
Mortality
Patients
Physicians
Prostheses
Recombinant Proteins - therapeutic use
Surgeons
Thrombocytopenia
Thromboembolism
Thrombosis
Treatment Failure
Treatment Outcome
Ultrasonic imaging
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Summary:A 49-year-old man was admitted with high-risk left ventricular thrombosis and systemic embolization. Prompt and complete resolution of the thrombus was achieved under intravenous lepirudin administration but not under full-dose heparin treatment. Medical physicians, including emergency medicine physicians, cardiologists, cardiac surgeons, and hematologists, should become more aware of these alternative anticoagulant treatments, especially in cases when other therapeutic options (such as thrombolysis or cardiac surgery) may be associated with high morbidity or mortality.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2011.04.018