Giant mobile left ventricular apical thrombus following silent infarction in a young patient: A case report

Abstract

Today, percutaneous coronary treatment and anticoagulation therapies are commonly used worldwide, which is why the incidence of reported left ventricular (LV) thrombus decreased. Despite modern methods, we still encounter thromboembolic complications resulting in morbidity and mortality in a large number of patients, especially after silent infarctions. Because of high embolism risk, early detection of LV thrombus is crucial. We present the rare and interesting case of a 34-year-old patient diagnosed with a large, fragmented, very mobile left ventricular apical thrombus after silent myocardial infarction due to total occlusion of left anterior descending coronary artery.

Keywords

• Silent myocardial infarction,Left ventricular thrombus,Embolism risk

Genç hastada sessiz enfarkt sonrası sol ventrikül apikal dev mobil trombüs: Olgu sunumu

Öz

Günümüzde perkütan koroner girişimler ve antikoagülan terapilerin dünya çapında yaygın kullanımı nedeniyle sol ventrikülde trombüs oluşma insidansı geçmişe göre daha azdır. Modern metodlara rağmen, özellikle sessiz enfarktlardan sonra olan ve geniş bir hasta popülasyonunda mortalite ve morbidite ile sonuçlanan tromboembolik komplikasyonlar ile karşılaşmaktayız. Yüksek emboli riski nedeniyle sol ventrikül trombüslerinin erken teşhisi kritik önem taşımaktadır. Sol ön inen koroner arterin total tıkanmasına bağlı sessiz enfarkt sonrası sol ventrikül apikal kısımda büyük, fragmante, ileri derecede mobil trombüs tanısı koyduğumuz ilginç ve nadir görülen 34 yaşındaki vakayı sunmaktayız. 

Anahtar Kelimeler

• Sessiz miyokard enfarktüsü,Sol ventrikül trombüsü,Emboli riski

References

1. 1. Tanaka D, Unai S, Diehl JT, Hirose H. Surgical removal of a large mobile left ventricular thrombus via left atriotomy. World Journal of Clinical Cases: WJCC. 2014;2(2):32.
2. 2. Wu JC, Solomon SD. Long-Term Consequences and Prognosis After Myocardial Infarction. Essential Echocardiography: A Companion to Braunwald's Heart Disease E-Book. 2018:204.
3. 3. Ates İ, Ulucan S, Kaya Z, Dogru M, Katlandur H, Keser A. Longitudinally Giant Left Ventricular Thrombus after Anterior Wall Myocardial Infarction. Acta Medica Anatolia. 2015;3(4).
4. 4. Domenicucci S, Chiarella F, Bellone P. Role of echocardiography in the assessment of left ventricular thrombus embolic potential after anterior acute myocardial infarction. Congestive Heart Failure. 2001;7(5):250-5.
5. 5. Chen C, Webster G, Morganroth J. Large mobile pedunculated left ventricular thrombus: Identification by two-dimensional echocardiography. Clinical Cardiology. 1981;4(4):189-92.
6. 6. Ye F, Silverstein BV, Khuddus MA, Bray CL, Lee AC. Giant Left Ventricular Thrombus in a Patient with Acute Ischemic Stroke: A Case Report and Minireview. Case Reports in Cardiology. 2018;2018.
7. 7. Nili M, Deviri E, Jortner R, Strasberg B, Levy MJ. Surgical removal of a mobile, pedunculated left ventricular thrombus: report of 4 cases. The Annals of Thoracic Surgery. 1988;46(4):396-400.
8. 8. Yalçın M, Katırcıoğlu EG, Yazman S, Tayfur KD, Ürkmez M. Troponin I levels before bypass surgery after acute myocardial infarction; When to operate? J Surg Med. 2018;2(3):228-32.