scholarly journals Spontaneous Retraction of an Intramyocardial Dissecting Hemorrhage and Multiple Left Ventricular Thrombus Formations in Subacute Myocardial Infarction and Antiphospholipid Syndrome: A Case Report with Long-term Follow-up

2006 ◽  
Vol 19 (5) ◽  
pp. 578.e5-578.e8 ◽  
Author(s):  
Edda Bahlmann ◽  
Carsten Schneider ◽  
Laura Vitali Serdoz ◽  
Martin Hoffmann-Riem ◽  
Thomas Broemel ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Antiphospholipid Syndrome ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Ventricular Thrombus ◽  
Long Term Follow Up

Long-term Follow-up of Left Ventricular Thrombus after Acute Myocardial Infarction

CHEST Journal ◽  
1984 ◽  
Vol 86 (4) ◽  
pp. 532-536 ◽  
Author(s):  
C.A. Visser ◽  
G. Kan ◽  
R.S. Meltzer ◽  
K.I. Lie ◽  
D. Durrer
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Ventricular Thrombus ◽  
Long Term Follow Up

scholarly journals The use of novel oral anticoagulants compared to vitamin K antagonists (warfarin) in patients with left ventricular thrombus after acute myocardial infarction

2020 ◽  
Author(s):  
Daniel A Jones ◽  
Paul Wright ◽  
Momin A Alizadeh ◽  
Sadeer Fhadil ◽  
Krishnaraj S Rathod ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Vitamin K ◽  
Oral Anticoagulants ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Novel Oral Anticoagulants ◽  
Secondary Outcome ◽  
Ventricular Thrombus

Abstract Aim Current guidelines recommend the use of vitamin K antagonist (VKA) for up to 3–6 months for treatment of left ventricular (LV) thrombus post-acute myocardial infarction (AMI). However, based on evidence supporting non-inferiority of novel oral anticoagulants (NOAC) compared to VKA for other indications such as deep vein thrombosis, pulmonary embolism (PE), and thromboembolic prevention in atrial fibrillation, NOACs are being increasingly used off licence for the treatment of LV thrombus post-AMI. In this study, we investigated the safety and effect of NOACs compared to VKA on LV thrombus resolution in patients presenting with AMI. Methods and results This was an observational study of 2328 consecutive patients undergoing coronary angiography ± percutaneous coronary intervention (PCI) for AMI between May 2015 and December 2018, at a UK cardiac centre. Patients’ details were collected from the hospital electronic database. The primary endpoint was rate of LV thrombus resolution with bleeding rates a secondary outcome. Left ventricular thrombus was diagnosed in 101 (4.3%) patients. Sixty patients (59.4%) were started on VKA and 41 patients (40.6%) on NOAC therapy (rivaroxaban: 58.5%, apixaban: 36.5%, and edoxaban: 5.0%). Both groups were well matched in terms of baseline characteristics including age, previous cardiac history (previous myocardial infarction, PCI, coronary artery bypass grafting), and cardiovascular risk factors (hypertension, diabetes, hypercholesterolaemia). Over the follow-up period (median 2.2 years), overall rates of LV thrombus resolution were 86.1%. There was greater and earlier LV thrombus resolution in the NOAC group compared to patients treated with warfarin (82% vs. 64.4%, P = 0.0018, at 1 year), which persisted after adjusting for baseline variables (odds ratio 1.8, 95% confidence interval 1.2–2.9). Major bleeding events during the follow-up period were lower in the NOAC group, compared with VKA group (0% vs. 6.7%, P = 0.030) with no difference in rates of systemic thromboembolism (5% vs. 2.4%, P = 0.388). Conclusion These data suggest improved thrombus resolution in post-acute coronary syndrome (ACS) LV thrombosis in patients treated with NOACs compared to VKAs. This improvement in thrombus resolution was accompanied with a better safety profile for NOAC patients vs. VKA-treated patients. Thus, provides data to support a randomized trial to answer this question.

scholarly journals The Role of Anticoagulation in Post-COVID-19 Concomitant Stroke, Myocardial Infarction, and Left Ventricular Thrombus: A Case Report

2021 ◽  
Vol 22 ◽  
Author(s):  
Phool Iqbal ◽  
Bushra Laswi ◽  
Muhammad Bilal Jamshaid ◽  
Aamir Shahzad ◽  
Hammad Shabir Chaudhry ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Ventricular Thrombus

scholarly journals Changes in mitral regurgitation following acute myocardial infarction: early and long-term follow-up

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
H Sharma ◽  
M Yuan ◽  
I Shakeel ◽  
A Radhakrishnan ◽  
S Brown ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Mitral Regurgitation ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Long Term Follow Up ◽  
Clinical Records ◽  
Long Term Mortality

Abstract Background Mitral regurgitation (MR) is commonly observed following acute myocardial infarction (MI). Localised left ventricular (LV) remodelling in the region of papillary muscles together with impaired myocardial contractility promote MR. There is a paucity of long-term follow-up studies to determine whether the severity of MR observed post-MI, changes with time. Purpose This study retrospectively followed up patients with MR detected following acute MI (AMI) to investigate changes in MR severity with time and assess for pre-discharge predictors of MR regression or progression. Methods Clinical records of 1000 patients admitted with AMI between 2016 and 2017 to a single centre were retrospectively interrogated. One hundred and nine patients met the inclusion criteria of MR on pre-discharge transthoracic echocardiography (TTE) and follow-up TTE scans. Echocardiographic parameters were investigated to determine predictors of progression or regression at follow-up. Patients were divided according to those who had early follow-up TTE (within 1-year) and late follow-up TTE (beyond 1-year). Results Early follow-up TTE was performed in 73 patients at a median of 6 (IQR 3–9) months. Patients had a mean age of 69±13 years and were predominantly male 50/73 (68%). At baseline, relative MR severities were: 49/73 (67%) mild MR, 23/73 (32%) moderate MR and 1 (1%) severe MR. At follow-up, MR had completely resolved in 18/73 (23%) patients, while 39/73 (53%) had mild MR, 15/73 (21%) moderate MR and 1 (1%) severe MR. Compared to patients with no resolution of MR, those with completel resolution were younger (mean age 62±16 vs 72±11 years; p=0.015) but there were no other significant differences between the groups. Resolution at early follow-up did not significantly influence long-term mortality rates. Late follow-up TTE was performed in 69 patients at a median 2.4 (IQR 2–3.2) years. Pre-discharge, 49/69 (71%) patients had mild MR and 20/69 (29%) moderate MR. At follow-up, MR had completely resolved in 18/69 (26%), and amongst patients with persistent MR, proportion of severities were: 37/69 (54%) mild MR, 11/69 (16%) moderate MR and 3/69 (4%) severe MR. Patients with progression of mild MR were more likely to have lower left ventricular ejection fraction (LVEF: 47±15 vs 57±12%; p=0.010) and greater indexed left ventricular end-systolic volume (LVESVi: 37±23 vs 25±14 ml/m2; p<0.001) on pre-discharge TTE. Resolution of MR at late follow-up was associated with a reduction in long-term mortality [deaths: 2/55 (3%) vs 3/14 (21%); p=0.022] at a mean follow-up of 4.2 years from MI. Conclusion MR observed following AMI completely resolved in approximately one-quarter of patients at 6-month and 2-year follow-up. Progression of mild MR at long-term follow-up appears to be associated with increased mortality and is predicted by lower LVEF and greater LVESVi pre-discharge. FUNDunding Acknowledgement Type of funding sources: None.

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