For the purpose of this paper our definition of an apical mural thrombus is a distinct mass of echoes, most commonly seen in the apex throughout the cardiac cycle, and in more than one view. Mural thrombi are most commonly seen between six and 10 days following an acute myocardial infarction (MI).

What is an apical thrombus?

For the purpose of this paper our definition of an apical mural thrombus is a distinct mass of echoes, most commonly seen in the apex throughout the cardiac cycle, and in more than one view. Mural thrombi are most commonly seen between six and 10 days following an acute myocardial infarction (MI).

What causes an apical thrombus?

A Virchow’s triad of factors – reduced ventricular motion, local myocardial injury and hypercoagulability/stasis of flow contribute to formation of LV thrombus. Reduced ventricular contractility – Blood stagnation in the weak non-contractile segment of the ventricle plays a major role in formation of thrombi.

How is LV thrombus treated?

Intravenous thrombolysis has also been used for treatment of documented LV thrombus. In a report of 16 patients with LV thrombus on echocardiography, urokinase was infused intravenously at a rate of 60 000 U/h for 2–8 days in combination with intravenous heparin (200 units/kg×12 h).

What causes ventricular thrombus?

Left ventricular (LV) thrombus may develop after acute myocardial infarction (MI) and occurs most often with a large, anterior ST-elevation MI (STEMI). However, the use of reperfusion therapies, including percutaneous coronary intervention and fibrinolysis, has significantly reduced the risk.

What does LVF stand for in medical terms?

LVF: 1. Left ventricular failure, failure of the left side of the heart. 2. Left ventricular function, the function of the left ventricle. In both of these senses, LVF is in contrast to RVF (right ventricular failure or function).

How common is LV thrombus?

The incidence of LV thrombus was 12.3% (26/210) by CMR and 6.2% (13/210) by two-dimensional echocardiography. Echocardiography had 50% sensitivity and 100% specificity for LV thrombus detection compared to CMR. LV thrombus was found in 23.6% of patients with anterior STEMI (22/93).

How long do you anticoagulation for LV thrombus?

Various societal guidelines recommend 3 to 6 months of anticoagulation (AC) with warfarin (or up till thrombus resolution) [3,4,5]. However, there is a lack of good evidence to guide these recommendations. All guidelines recommend using vitamin K antagonists.

How long does it take for an LV thrombus to dissolve?

The LV thrombus size was reduced in 121 (76.1%) cases with total resolution in 99 (62.3%) within a median of 103 days (interquartile range, 32-392 days).

How is LV thrombus diagnosed?

Non-contrast echocardiography (echo) detects LV thrombus based on anatomical appearance. This approach can be straightforward when thrombus is large in size and protuberant in shape, but challenging when thrombus is small or mural.

What are the warning signs of thrombosis?

DVT signs and symptoms can include:

  • Swelling in the affected leg. Rarely, there’s swelling in both legs.
  • Pain in your leg. The pain often starts in your calf and can feel like cramping or soreness.
  • Red or discolored skin on the leg.
  • A feeling of warmth in the affected leg.

What is an apical mural thrombus?

What is an apical mural thrombus? Left ventricular thrombus is a blood clot (thrombus) in the left ventricle of the heart. LVT is a common complication of acute myocardial infarction (AMI). Typically the clot is a mural thrombus, meaning it is on the wall of the ventricle.

What does acute thrombus look like?

Acute thrombus shows high signal intensity on T1- and T2-weighted images while older thrombus has low signal intensity in both T1 and T2 sequences and occasionally shows evidence of calcification.41Presence of an immobile thrombus with no protruding elements also suggests low embolic potential.

Is apical thrombus present in LGE cardiac magnetic resonance imaging?

The presence of apical thrombus (arrow) is clearly evident in LGE cardiac magnetic resonance (b) compared to cine-cardiac magnetic resonance (a). Recent evidence highlights that delay of imaging for more than 5 days after acute MI was associated with significantly higher detection rates of LVT compared to imaging within 5 days.

What is the prevalence of LV thrombus after acute MI (AMI)?

LV thrombus after acute MI (AMI) has declined significantly since the introduction of reperfusion therapy. The current estimate is that LV thrombus occurs in up to 6.3% of patients with ST-segment elevation MI (STEMI) and 19.2% of patients with anterior wall STEMI complicated by LV ejection fraction <50%.