BACKGROUND Presently,there is no established standard anti-blood clot therapy for patients facing acute myocardial infarction(AMI)complicated by left ventricular thrombus(LVT).While vitamin K antagonists are the prefe...BACKGROUND Presently,there is no established standard anti-blood clot therapy for patients facing acute myocardial infarction(AMI)complicated by left ventricular thrombus(LVT).While vitamin K antagonists are the preferred choice for oral blood thinning,determining the best course of blood-thinning medication remains challenging.It is unclear if non-vitamin K antagonist oral blood thinners have different effectiveness in treating LVT.This study significantly contributes to the medical community.CASE SUMMARY The blood-thinning treatment of a patient with AMI and LVT was analyzed.Triple blood-thinning therapy included daily enteric-coated aspirin tablets at 0.1 g,daily clopidogrel hydrogen sulfate at 75 mg,and dabigatran etexilate at 110 mg twice daily.After 15 d,the patient’s LVT did not decrease but instead increased.Clinical pharmacists comprehensively analyzed the cases from the perspective of the patient’s disease status and drug interaction.The drug regimen was reformulated for the patient,replacing dabigatran etexilate with warfarin,and was administered for six months.The clinical pharmacist provided the patient with professional and standardized pharmaceutical services.The patient’s condition was discharged after meeting the international normalized ratio value(2-3)criteria.The patient fully complied with the follow-up,and the time in the therapeutic range was 78.57%,with no serious adverse effects during pharmaceutical monitoring.CONCLUSION Warfarin proves to be an effective drug for patients with AMI complicated by LVT,and its blood-thinning course lasts for six months.展开更多
BACKGROUND Left ventricular thrombus is a rare condition,for which appropriate treatments are not extensively studied.Although it can be treated by thrombectomy,such surgery can be difficult and risky,and not every pa...BACKGROUND Left ventricular thrombus is a rare condition,for which appropriate treatments are not extensively studied.Although it can be treated by thrombectomy,such surgery can be difficult and risky,and not every patient can tolerate the surgery.CASE SUMMARY We report a case of a middle-aged man receiving veno-arterial extracorporeal membrane oxygenation(VA-ECMO)for acute myocardial infarction who developed left ventricular thrombus despite systemic anticoagulation.After systemic thrombolysis with urokinase,the left ventricular thrombus disappeared,ECMO was successfully withdrawn 9 days later,and the patient recovered and was discharged from hospital.CONCLUSION Systemic thrombolysis is a treatment option for left ventricular thrombus in addition to anticoagulation and thrombectomy.展开更多
This paper reports a case of a 38-year-old young man with a lower extremity arterial thrombus diagnosed by ultrasound, which was traced back to the left ventricular thrombus. By reviewing the relevant literature, the ...This paper reports a case of a 38-year-old young man with a lower extremity arterial thrombus diagnosed by ultrasound, which was traced back to the left ventricular thrombus. By reviewing the relevant literature, the relationship between lower extremity arterial thrombosis and left ventricular thrombosis is described, and which examination method is the most valuable in the diagnosis of thrombosis is discussed.展开更多
Background： Left ventricular thrombus （LVT） is reported to be a common complication in acute myocardial infarction （AMI） patients. And it has the potential to cause systemic embolism. This retrospective study was...Background： Left ventricular thrombus （LVT） is reported to be a common complication in acute myocardial infarction （AMI） patients. And it has the potential to cause systemic embolism. This retrospective study was to present the current situation of LVT in clinical practice, as well as to evaluate the clinical characteristics and the risk factors of LVT alter AMI. Methods： LVT cases （n = 96） were identified from 13,732 AMI （non-ST elevation myocardial infarction was excluded） patients in Fuwai Hospital＇s electronic medical records system from January 2003 to January 2013. The controls （n = 192） were gender- and age-matched AMI patients without LVT during this period. A conditional logistic regression （fitted by the Cox model） was performed to identity the independent risk factors. Results： The incidence of LVT after AMI was 0.7%. Univariate analysis indicated that the anterior myocardial infarction （especially extensive anterior myocardial infarction）, lower left ventricular ejection traction （LVEF）, LVEF ≤40%, severe regional wall motion abnonnalities （RWMA）, pericardial effusion, and left ventricular aneurysm were all related to LVT after AMI. The independent risk factors obtained from the conditional logistic regression analysis were lower LVEF （odds ratio （OR） = 0.891, 95% confidence interval （CI）： 0.828-0.960）, extensive anterior myocardial infarction （OR = 6.403, 95% CI： 1,769~3.169）, severe RWMA （OR = 7.348, 95% （7：1.32340.819）. and left ventricular aneurysm （OR = 6.955.95% CI： 1.673-28.921 ）. Conclusions： This study indicated that lower LVEF. extensive anterior myocardial infarction, severe RWMA, and left ventricular aneu,ysm were independent risk factors of LVT after AMI. It also suggested that further efforts are needed for the LVT diagnosis after AMI in clinical practice.展开更多
文摘BACKGROUND Presently,there is no established standard anti-blood clot therapy for patients facing acute myocardial infarction(AMI)complicated by left ventricular thrombus(LVT).While vitamin K antagonists are the preferred choice for oral blood thinning,determining the best course of blood-thinning medication remains challenging.It is unclear if non-vitamin K antagonist oral blood thinners have different effectiveness in treating LVT.This study significantly contributes to the medical community.CASE SUMMARY The blood-thinning treatment of a patient with AMI and LVT was analyzed.Triple blood-thinning therapy included daily enteric-coated aspirin tablets at 0.1 g,daily clopidogrel hydrogen sulfate at 75 mg,and dabigatran etexilate at 110 mg twice daily.After 15 d,the patient’s LVT did not decrease but instead increased.Clinical pharmacists comprehensively analyzed the cases from the perspective of the patient’s disease status and drug interaction.The drug regimen was reformulated for the patient,replacing dabigatran etexilate with warfarin,and was administered for six months.The clinical pharmacist provided the patient with professional and standardized pharmaceutical services.The patient’s condition was discharged after meeting the international normalized ratio value(2-3)criteria.The patient fully complied with the follow-up,and the time in the therapeutic range was 78.57%,with no serious adverse effects during pharmaceutical monitoring.CONCLUSION Warfarin proves to be an effective drug for patients with AMI complicated by LVT,and its blood-thinning course lasts for six months.
文摘BACKGROUND Left ventricular thrombus is a rare condition,for which appropriate treatments are not extensively studied.Although it can be treated by thrombectomy,such surgery can be difficult and risky,and not every patient can tolerate the surgery.CASE SUMMARY We report a case of a middle-aged man receiving veno-arterial extracorporeal membrane oxygenation(VA-ECMO)for acute myocardial infarction who developed left ventricular thrombus despite systemic anticoagulation.After systemic thrombolysis with urokinase,the left ventricular thrombus disappeared,ECMO was successfully withdrawn 9 days later,and the patient recovered and was discharged from hospital.CONCLUSION Systemic thrombolysis is a treatment option for left ventricular thrombus in addition to anticoagulation and thrombectomy.
文摘This paper reports a case of a 38-year-old young man with a lower extremity arterial thrombus diagnosed by ultrasound, which was traced back to the left ventricular thrombus. By reviewing the relevant literature, the relationship between lower extremity arterial thrombosis and left ventricular thrombosis is described, and which examination method is the most valuable in the diagnosis of thrombosis is discussed.
文摘Background： Left ventricular thrombus （LVT） is reported to be a common complication in acute myocardial infarction （AMI） patients. And it has the potential to cause systemic embolism. This retrospective study was to present the current situation of LVT in clinical practice, as well as to evaluate the clinical characteristics and the risk factors of LVT alter AMI. Methods： LVT cases （n = 96） were identified from 13,732 AMI （non-ST elevation myocardial infarction was excluded） patients in Fuwai Hospital＇s electronic medical records system from January 2003 to January 2013. The controls （n = 192） were gender- and age-matched AMI patients without LVT during this period. A conditional logistic regression （fitted by the Cox model） was performed to identity the independent risk factors. Results： The incidence of LVT after AMI was 0.7%. Univariate analysis indicated that the anterior myocardial infarction （especially extensive anterior myocardial infarction）, lower left ventricular ejection traction （LVEF）, LVEF ≤40%, severe regional wall motion abnonnalities （RWMA）, pericardial effusion, and left ventricular aneurysm were all related to LVT after AMI. The independent risk factors obtained from the conditional logistic regression analysis were lower LVEF （odds ratio （OR） = 0.891, 95% confidence interval （CI）： 0.828-0.960）, extensive anterior myocardial infarction （OR = 6.403, 95% CI： 1,769~3.169）, severe RWMA （OR = 7.348, 95% （7：1.32340.819）. and left ventricular aneurysm （OR = 6.955.95% CI： 1.673-28.921 ）. Conclusions： This study indicated that lower LVEF. extensive anterior myocardial infarction, severe RWMA, and left ventricular aneu,ysm were independent risk factors of LVT after AMI. It also suggested that further efforts are needed for the LVT diagnosis after AMI in clinical practice.
