Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA.
Division of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, VA.
J Cardiovasc Pharmacol. 2021 Sep 1;78(3):361-371. doi: 10.1097/FJC.0000000000001064.
Intracardiac thrombi can occur in a variety of locations and are frequently encountered in clinical practice. Yet evidence-based guidance for clinicians managing patients with intracardiac thrombi is often limited. This review summarizes what is known regarding the prevalence of intracardiac thrombus, diagnostic strategies, clinical relevance, and treatment options, focusing on four specific types of thrombus for which recent research has shifted clinical understanding and treatment decisions: (1) left atrial appendage thrombus, (2) cardiac implantable electronic device lead thrombus, (3) bioprosthetic aortic valve thrombus, and (4) left ventricular thrombus. Additional studies, ideally prospective, randomized, and head-to-head in design, are needed to better inform best practices in patients with intracardiac thrombi.
心腔内血栓可发生于多种部位,在临床实践中较为常见。然而,对于管理心腔内血栓患者的临床医生而言,循证指导往往有限。本综述总结了心腔内血栓的发生率、诊断策略、临床相关性和治疗选择方面的已知内容,重点关注了四种特定类型的血栓,最近的研究改变了人们对这些血栓的临床认识和治疗决策:(1)左心耳血栓;(2)心脏植入式电子设备导线血栓;(3)生物瓣主动脉瓣血栓;以及(4)左心室血栓。需要开展更多研究,理想情况下应为前瞻性、随机、头对头设计的研究,以便更好地为心腔内血栓患者提供最佳实践建议。