Rathi N, Maheshwari N, Kumari D, Sachdewani R K, Memon N A, Memon F.
Left ventricular thrombus in acute myocardial infarction.
Pak Heart J Jan ;42(1):09-13.

Objective: To determine Left ventricular thrombus (LVT) in acute Myocardial infarction (MI) and to find out the correlation of risk factors with development of LVT. Study Design: Hospital based observational study. Place and Duration: Department of Cardiology, Liaquat University Hospital Hyderabad between November 2005 to November 2006. Patients and Methods: 280 consecutive patients presented with first episode of acute Myocardial infarction were included. Patients with previous history of Myocardial infarction, rheumatic heart disease, dilated cardiomyopathy and mural thrombus were excluded. Baseline characteristics were recorded on the proforma. Two dimensional echocardiography was performed on day 3, at the time of discharge, 3 and 6 months after infarction. Two echo cardiographers blinded to clinical details separately reviewed the echo images. Descriptive and inferential statistical analysis was performed using SPSS version 16.0. Results: Two hundred and eighty patients with first episode of acute MI were studied; 214(76.4%) were male and 66(23.6%) were female. Mean age of patients was 54.08 ± 11.9 SD. Left Ventricular Thrombi (LVT) was found in 50/280 (17.86%) patients detected by 2-D echo method. 3(6%) patients died while in the coronary care unit and 7 (14%) with LVT failed to follow up. In remaining 14/40 (35%) patients’ thrombus once detected, was present during the entire echocardiographic follow up and became organized. However in 26/40 (65%) patients thrombus disappearance was noted on follow up echocardiographic studies. Only 3/50 (6%) patients had complication of systemic embolization, all in the CNS. Among risk factors only smoking and Diabetes Mellitus were found to be statistically significant. LVT was seen in patients with decreased left ventricular wall motion especially anterioapical wall akinesia. Conclusion: LVT is important complication of acute myocardial infarction. If diagnosed and anticoagulated earlier, further risk of complications and its potential to embolize can be minimized

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