Left ventricular thrombus in acute myocardial infarction

Catastrophic morbidity or mortality from cardiogenic cerebral embolism occurs in approximately 2000 cases each year in the Netherlands'. Left ventricular thrombus after myocardial infarction is a source of such emboli which is largely preventable by systemic anticoagulation. However, anticoagulants induce a bleeding risk and must be given only when the risk of embolism is increased''. Two-dimensional echocardiography has played a pivotal role in defining the natural history of thrombus formation in patients with acute myocardial infarction. The role of echocardiography has recently been expanded by use of Doppler echocardiography since it has been shown that study of intraventricular flow patterns provides a unique and pathophysiologically rational means of estimating the risk of thrombus formation'' with potentially important implications for the management of anticoagulant drugs.