Left ventricular mural thrombus is a recognized complication of acute MI, particularly large anterior infarctions, and is managed with imaging for diagnosis and anticoagulation to prevent embolization.
Reinforces standard post-MI LV thrombus management with imaging and anticoagulation; leaves optimal duration and modalities open for prospective trials.
Left ventricular mural thrombus is a well-recognized complication of acute myocardial infarction. In survivors of infarction, the incidence with which mural thrombus occurs is influenced by the location and magnitude of infarction, so that it occurs commonly in those with large anterior Q-wave infarctions, particularly in the presence of a left ventricular aneurysm. Echocardiography, radionuclide imaging with indium-111 labeled platelets, computerized tomography, and magnetic resonance imaging may be used to identify a left ventricular mural thrombus. Acute and chronic anticoagulation with heparin and warfarin, respectively, is given to prevent further thrombus formation and to reduce the incidence of systemic embolization.
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Keeley et al. (1996) studied this question.
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