Skip to main content

Detection and evaluation of left ventricular thrombosis in myocardial infarction

Role of echocardiography

  • Chapter
Ultrasound in Coronary Artery Disease

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 113))

  • 77 Accesses

Abstract

Intraventricular thrombosis is a complication met with relatively frequently during acute anterior myocardial infarction [1], especially if there is also an aneurysmatic dilatation. In this clinical situation, before the advent of echocardiography, diagnosis was retrospective and based on the appearance of a systemic embolism. After the acute phase of myocardial infarction, the only available diagnostic method was contrast ventriculography: this method has the drawback of being neither very sensitive (it cannot visualize laminated thrombi) nor specific (it may show up false filling defects in large ventricles). Moreover, its poor repeatability means it is not very suitable for following up the behaviour of thrombi.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Asinger RW, Mikell FL, Elsperger J, Hodges M (1981) Incidence of left ventricular thrombosis after acute transmural myocardial infarction. Serial evaluation by two-dimensional echocardiography. N Engl J Med 305: 297–302.

    Article  PubMed  CAS  Google Scholar 

  2. Frisbie JH, Tow DE, Sasahara AA, Barsamian EM, Parisi AF (1976) Non invasive detection of intracardiac thrombosis. 131-I fibrinogen cardiac survey. Circulation 6: 989–991.

    Google Scholar 

  3. Kramer RS, Ashburn WL, Vasko JS (1967) Detection of intracardiac thrombi using radioiodinated antifibrinogen (RIAF) and precordial scanning: Experimental and clinical studies. Ann. Surg 166: 173–177.

    Article  PubMed  CAS  Google Scholar 

  4. Stratton JR, Ritchie JL, Hammermeister KE, Kennedy JW, Hamilton GW (1981) Detection of left ventricular thrombi with radionuclide angiography. Am J Cardiol 48: 565–72.

    Article  PubMed  CAS  Google Scholar 

  5. Tomoda H, Hoshiai M, Furuya H, Kuribayashi S, Ootaki M, Matsuyama S, Koide S, Kawada S, Shotsu A (1983) Evaluation of intracardiac thrombus with computed tomography. Am J Cardiol 51: 843–52.

    Article  PubMed  CAS  Google Scholar 

  6. Ezekowitz MD, Wilson DA, Smith EO, Burow RD, Harrison LH, Parker DE, Elkins RC, Peyton M, Taylor FB (1982) Comparison of indium 111 platelet scintigraphy and two- dimensional echocardiography in the diagnosis of left ventricular thrombi. New Engl J Med 306: 1509–13.

    Article  PubMed  CAS  Google Scholar 

  7. Horgan JH, O’M Shiel F, Goodman AC (1976) Demonstration of left ventricular thrombus by conventional echocardiography. J Clin Ultrasound 4: 287–8.

    Article  PubMed  CAS  Google Scholar 

  8. Meltzer RS, Guthaner D, Rakowski H, Popp RL, Martin RP (1979) Diagnosis of left ventricular thrombi by two-dimensional echocardiography. Br Heart J 42: 651–5.

    Article  Google Scholar 

  9. Asinger RW, Mikell FL, Sharma B, Hodge M (1981) Observations on detecting left ventricular thrombus with two-dimensional echocardiography: Emphasis on avoidance of false positive diagnoses. Am J Cardiol 47: 145–56.

    Article  PubMed  CAS  Google Scholar 

  10. Stratton JR, Lighty GW, Pearlman AS, Ritchie JL (1982) Detection of left ventricular thrombus by two-dimensional echocardiography: Sensitivity, specificity and causes of uncertainty. Circulation 66: 156–66.

    Article  PubMed  CAS  Google Scholar 

  11. Visser CA, Kan G, David GK, Lie KI, Durrer D (1983) Two-dimensional echocardiography in the diagnosis of left ventricular thrombus: A prospective study of 67 patients with anatomic validation. Chest 83: 228–32.

    Article  PubMed  CAS  Google Scholar 

  12. Green SE, Joynt LE, Fitzgerald PJ, Rubenson DS, Popp RL (1983) In vivo ultrasonic tissue characterization of human intracardiac masses. Am J Cardiol 51: 231–6.

    Article  PubMed  CAS  Google Scholar 

  13. Hellerstein HK, Martin JW (1946) Incidence of thromboembolic lesions accompanying myocardial infarction. Am Heart J 32: 443–52.

    Article  Google Scholar 

  14. Working party on anticoagulant therapy in coronary thrombosis: Assessment of short-term anticoagulant administration after cardiac infarction. Brit Med J (1969) 1: 335–42.

    Google Scholar 

  15. Veterans Administration Cooperative Clinical Trial Group (1973) Anticoagulants in acute myocardial infarction. Results of a cooperative clinical trial. JAMA 225: 724–29.

    Article  Google Scholar 

  16. Keating AC, Gross SA, Schlamowitz RA, Glassman JG, Mazur JH, Pitt WA, Miller D (1983) Mural thrombi in myocardial infarctions. Prospective evaluation by two-dimen- sional echocardiography. Am J Med 74: 989–95.

    Article  PubMed  CAS  Google Scholar 

  17. Haugland JM, Asnger RW, Mikell FL, Elsperger J, Hodges M (1984) Embolic potential of left ventricular thrombus detected by two-dimensional echocardiography. Circulation 70: 588–98.

    Article  PubMed  CAS  Google Scholar 

  18. Visser CA, Kan G, Meltzer RS, Dunning A, Roelandt J (1985) Embolic potential of the ventricular thrombi after myocardial infarction: A two-dimensional echocardiographic study of 119 patients. J Am Coll Cardiol 5: 1276–80.

    Article  PubMed  CAS  Google Scholar 

  19. Tramarin R, Pozzoli M, Vecchio C (1982) Trombosi ventricolare nell’infarto miocardico recente. Studio ecocardiografico. G. Ital Cardiol 12: 397–404.

    PubMed  CAS  Google Scholar 

  20. Domenicucci S, Bellotti P, Chiarella F, Lupi G, Vecchio C (1987) Spontaneous morphologic changes in left ventricular thrombi: A prospective two-dimensional echocardiographic study. Circulation 75: 737–43.

    Article  PubMed  CAS  Google Scholar 

  21. Stratton JR, Resnick AD (1987) Increased embolic risk in patients with left ventricular thrombi. Circulation 75: 1004–11.

    Article  PubMed  CAS  Google Scholar 

  22. Friedmand MJ, Carlson K, Marcus FI, Woolfenden JM (1982) Clinical correlations in patients with acute myocardial infarction and left ventricular thrombus detected by two- dimensional echocardiography. Am J Med 72: 894–8.

    Article  Google Scholar 

  23. The SCATI Group (1989) Randomized Controlled Trial of Subcutaneous Calcium-heparin in acute myocardial infarction. Lancet (July 22 ): 182–186.

    Google Scholar 

  24. Tramarin R, Pozzoli M, Febo O, Opasich C, Colombo E, Cobelli F, Specchia (1986) Two- dimensional echocardiographic assessment of anticoagulant therapy in left ventricular thrombosis early after acute myocardial infarction. Eur Heart J 7: 482–492.

    PubMed  CAS  Google Scholar 

  25. Spirito P, Bellotti P, Chiarella F, Domenicucci S, Sementa A, Vecchio C (1985) Prognostic significance and natural history of left ventricular thrombi in patients with acute anterior myocardial infarction: A two-dimensional echocardiographic study. Circulation 72: 774–80.

    Article  PubMed  CAS  Google Scholar 

  26. Kremer P, Fiebig R, Tilsner V, Bleifeld W, Mathey DG (1985) Lysis of left ventricular thrombi with urokinase. Circulation 72: 112–8.

    Article  PubMed  CAS  Google Scholar 

  27. Gruppo Italiano per lo Studio della Streptochinasi nell’infarto Miocardico (GISSI) (1985) Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet 1: 397–422.

    Google Scholar 

  28. Wilcox RG, Von Der Lippe G, Olsson CG, Jensen G, Skene AM, Hampton JR for the ASSET Study Group (1988) Trial of tissue plasminogen activator for mortality reduction in acute myocardial infarction. Anglo-Scandinavian Study of Early Thrombolysis (ASSET). Lancet 2: 525–30.

    Article  PubMed  CAS  Google Scholar 

  29. The ISAM Study Group (1986) A prospective trial of intravenous streptokinase in acute myocardial infarction (ISAM): Mortality, morbidity and infarct size at 21 days. N Engl J Med 314: 1465–71.

    Article  Google Scholar 

  30. Mikell FL, Asinger RW, Elsperger KJ, Anderson RW, Hodges M (1982) Regional stasis of blood in the dysfunctional left ventricle echocardiographic detection and differentiation from early thrombosis. Circulation 66: 755–63.

    Article  PubMed  CAS  Google Scholar 

  31. Iliceto S, Antonelli G, Sorino M, Biasco G, Rizzon P (1985) Dynamic intracavitary left atrial echoes in mitral stenosis. Am J Cardiol 55: 603–6.

    Article  PubMed  CAS  Google Scholar 

  32. Iliceto S, Papa A, Antonelli G, Sorino M, Amico A (1985) Spontaneous contrast echocardiography. Echocardiography 5: 455–65.

    Google Scholar 

  33. Mikell FL, Asinger RW, Elsperger KJ, Anderson RW, Hodges (1982) Tissue acoustic properties of fresh left ventricular thrombi and visualization by two dimensional echocardiography: Experimental observations. Am J Cardiol 49: 1157–65.

    Article  PubMed  CAS  Google Scholar 

  34. Lloret RL, Cortada X, Bradford J, Metz MN, Kinney EL (1985) Classification of left vetricular thrombi by their history of systemic embolization using pattern recognition of two- dimensional echocardiograms. Am Heart J 110: 761–5.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1991 Kluwer Academic Publishers

About this chapter

Cite this chapter

Amico, A.F. et al. (1991). Detection and evaluation of left ventricular thrombosis in myocardial infarction. In: Iliceto, S., Rizzon, P., Roelandt, J.R.T.C. (eds) Ultrasound in Coronary Artery Disease. Developments in Cardiovascular Medicine, vol 113. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-0611-2_14

Download citation

  • DOI: https://doi.org/10.1007/978-94-009-0611-2_14

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-6762-1

  • Online ISBN: 978-94-009-0611-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics