Key result
This narrative review highlights the utility of transthoracic echocardiography, including contrast agents and sequential imaging, for detecting and managing left ventricular thrombus after anterior MI.
Why the study?
CMR is the gold standard for detecting LVT after anterior MI but is time-consuming, expensive, and not universally available for repeated exams, highlighting the need to evaluate the role of echocardiographic guidance.
Does echocardiographic-guided management improve outcomes in patients with recent anterior myocardial infarction complicated by left ventricular thrombus?
Does echocardiographic-guided management improve outcomes in patients with recent anterior myocardial infarction complicated by left ventricular thrombus?
Transthoracic echocardiography, particularly with contrast agents and sequential imaging, represents a practical and valuable tool for the detection and management of left ventricular thrombus following anterior myocardial infarction.
Supports contrast-enhanced TTE for LV thrombus detection after anterior MI; leaves open whether echo-guided management improves outcomes.
Despite advancement in therapy and management, left ventricular thrombus (LVT) after anterior myocardial infarction (MI) is sporadically encountered and remains associated with a very high risk of major cardiovascular events and mortality. Cardiac magnetic resonance (CMR) is considered the gold standard technique for LVT detection, but it is a time-consuming and expensive test not available in all centers, especially when repeated examinations are necessary. Transthoracic echocardiography represents a useful tool to screen for LVT and to identify predictors of high risk of developing LVT. The advances in ultrasound technology and the use of contrast agents may potentially help clinicians to identify LVT and the use of sequential echocardiography for each patient with acute MI complicated by LVT may provide an opportunity to quantify regression and its correlation with outcomes to tailor the management of these patients. Hence, this narrative review focuses on the added value of echocardiographic-guided LVT management in patients with recent anterior MI to reduce mortality and morbidity excess related to LVT based on current evidence.
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Barbieri et al. (2020) conducted a review in Left ventricular thrombus after anterior myocardial infarction. Echocardiographic-guided management was evaluated. This narrative review highlights the utility of transthoracic echocardiography, including contrast agents and sequential imaging, for detecting and managing left ventricular thrombus after anterior MI.
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