Parma University Hospital.
Acta Biomed. 2021 Apr 30;92(S1):e2021053. doi: 10.23750/abm.v92iS1.9324.
A a 80-year-old male underwent routine transthoracic echocardiography the day after primary percutaneous revascularization procedure for ST-elevation myocardial infarction. When ultrasound contrast was injected, regular contrast-enhancement of the left ventricle (LV) excluded the presence of thrombus. A second echocardiogram, performed four months later, showed a hyperechoic image in the LV apex, which was confirmed after contrast injection as a thrombus. Four weeks later, a third follow-up echocardiogram appears apparently normal. However, contrast injection clearly demonstrates a new apex thrombus, in a slightly different location from the one detected previously. Standard echocardiography is often inconclusive or falsely negative regarding the detection of apical thrombus. Maybe the time has come for routine contrast-echo screening in post-myocardial infarction patients with the high likelihood of thrombus, such as in cases of apical infarction, even if the standard echocardiogram appears unremarkable.
一位 80 岁男性因 ST 段抬高型心肌梗死行急诊经皮冠状动脉介入治疗后次日接受了常规经胸超声心动图检查。当注射超声造影剂时，左心室（LV）的常规增强排除了血栓的存在。四个月后进行的第二次超声心动图检查显示 LV 心尖部呈高回声图像，在注射造影剂后证实为血栓。四周后，第三次随访超声心动图检查结果似乎正常。然而，造影剂注射清楚地显示了新的心尖部血栓，其位置与之前检测到的略有不同。对于心尖部血栓的检测，标准超声心动图通常不确定或假阴性。也许现在是时候对高血栓风险的心肌梗死患者（如心尖部梗死）进行常规造影超声心动图筛查了，即使标准超声心动图无明显异常。
