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Left ventricular thrombus (LVT) is a potentially fatal complication of anterior myocardial infarction (MI), affecting 5.4% of all MIs and 7–15% of anterior MIs (Delewi R, et al. Heart. 98(23):1743-1749, 2012). Although commonly associated with anterior MIs, LV thrombus should also be considered in cases of severe apical dyskinesis, LV aneurysm, LV pseudoaneurysm, and dilated cardiomyopathies (Delewi R, et al. Heart. 98(23):1743-1749, 2012; Srichai et al. Am Heart J. 152(1):75-84, 2006). Transthoracic echocardiography remains the mainstay for detecting LVT, and the addition of contrast to traditional echocardiography significantly improves its diagnostic capabilities (Templin et al. N Engl J Med. 373(10):929-938, 2015). When performing an echocardiogram to detect LVT, the examination should consist of parasternal long, parasternal short, and apical 2, 3, and 4 chamber views (Weinsaft et al. Cardiovasc Imaging. 4(7):702-712, 2011; Armstrong and Ryan. Feigenbaum’s echocardiography: Ebook without multimedia. eighth ed. Wolters Kluwer Health, 2018). Obtaining off-axis or tangential apical views, using probes with different frequencies, varying the gain settings, and adjusting the depth of field can reduce the risk of false positive studies (Armstrong and Ryan. Feigenbaum’s echocardiography: Ebook without multimedia. eighth ed. Wolters Kluwer Health, 2018; Delewi, et al. Eur J Radiol. 2012;81(12):3900-3904, 2012). Contrast-enhanced echocardiography should be considered in all high-risk patients and in cases where the endocardial border is not clearly defined (Porter, et al. J Am Soc Echocardiogr. 31(3):241-274, 2018).

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Left Ventricular Thrombus Part 1

  • 章节

  • 发表日期：

    2025年

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  • Donald R. Maberry,
  • Babar Fiza

摘要

Left ventricular thrombus (LVT) is a potentially fatal complication of anterior myocardial infarction (MI), affecting 5.4% of all MIs and 7–15% of anterior MIs (Delewi R, et al. Heart. 98(23):1743-1749, 2012). Although commonly associated with anterior MIs, LV thrombus should also be considered in cases of severe apical dyskinesis, LV aneurysm, LV pseudoaneurysm, and dilated cardiomyopathies (Delewi R, et al. Heart. 98(23):1743-1749, 2012; Srichai et al. Am Heart J. 152(1):75-84, 2006). Transthoracic echocardiography remains the mainstay for detecting LVT, and the addition of contrast to traditional echocardiography significantly improves its diagnostic capabilities (Templin et al. N Engl J Med. 373(10):929-938, 2015). When performing an echocardiogram to detect LVT, the examination should consist of parasternal long, parasternal short, and apical 2, 3, and 4 chamber views (Weinsaft et al. Cardiovasc Imaging. 4(7):702-712, 2011; Armstrong and Ryan. Feigenbaum’s echocardiography: Ebook without multimedia. eighth ed. Wolters Kluwer Health, 2018). Obtaining off-axis or tangential apical views, using probes with different frequencies, varying the gain settings, and adjusting the depth of field can reduce the risk of false positive studies (Armstrong and Ryan. Feigenbaum’s echocardiography: Ebook without multimedia. eighth ed. Wolters Kluwer Health, 2018; Delewi, et al. Eur J Radiol. 2012;81(12):3900-3904, 2012). Contrast-enhanced echocardiography should be considered in all high-risk patients and in cases where the endocardial border is not clearly defined (Porter, et al. J Am Soc Echocardiogr. 31(3):241-274, 2018).