[Left ventricular mural thrombus in acute anterior myocardial infarct].

Fifty-six consecutive patients with acute anterior infarction were studied by two-dimensional echocardiography to determine the incidence and complications of left-ventricular thrombosis. Mean follow-up period was 4.4 months. Left-ventricular thrombus was demonstrated in 14 patients (25%) between 25 and 54 days after infarction (group A), in 42 patients (group B) it was not demonstrated. Apical and septal dyskinesis, and Forrester's hemodynamic subset-III were significantly (P less than 0.02) associated with thrombus development. Ten patients of group A received heparin (6.6 days mean); the remaining four patients received aspirin and dipyridamole. Thrombi formation were not significantly prevented with both treatments (chi 2 = 0.635). During follow-up period, thrombus persisted in 6 patients of group A, all of them with apical and septal dyskinesis. Three patients had a cerebrovascular accident (5.3%), one of them of group A; no heparin anticoagulation was administered in two. We conclude that apical and septal dyskinesis during acute anterior infarction is generally associated with mural thrombi development. Due to the embolic risk therapeutic anticoagulation must be considered in these patients.