Prophylaxis of Recurrent Embolism of Intracardiac Origin

Recurrent embolism secondary to intracardiac mural thrombi is known to occur in a number of forms of heart disease, the most frequent of which is chronic rheumatic heart disease associated with auricular fibrillation. Major arterial occlusions by emboli constitute one of the most serious complications encountered in patients with chronic cardiac disease. A change in rhythm to auricular fibrillation occurs eventually in approximately 25 per cent of patients with chronic rheumatic heart disease. 1 Both auricular fibrillation and advancing age have been determined to increase the possibility of mural thrombus formations, 2 thus predisposing to the more frequent discharge of emboli from the intracardiac thrombi. Between 13 and 56 per cent of postmortem examinations of patients with chronic rheumatic heart disease reveal mural thrombus formations in one or more chambers, 3 while the incidence of clinical embolism has been estimated to be between 4 and 8 per cent. 4 The