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巨大左心室血栓导致双侧大脑后动脉卒中:一例报告并文献复习

Massive Left Ventricular Thrombus Causing Bilateral Posterior Cerebral Artery Stroke: A Case Report and Review of Literature.

作者信息

Jain Ashali, Haider Asad, Jones Tyler S

机构信息

Internal Medicine, University of Central Florida College of Medicine/HCA Florida North Florida Hospital, Gainesville, USA.

出版信息

Cureus. 2022 Aug 1;14(8):e27585. doi: 10.7759/cureus.27585. eCollection 2022 Aug.

Abstract

Left ventricular thrombus (LVT) is a major complication of acute myocardial infarction (MI). Here, we describe the case of a 36-year-old female with a history of acute anterior MI six years prior to hospitalization, who presented with bilateral vision loss due to a bilateral embolic posterior cerebral artery (PCA) stroke in the setting of a 5.7 x 1.7 cm LVT. She underwent bilateral PCA thrombectomy, which led to improvement of her symptoms. Her LVT was managed non-surgically with apixaban and clopidogrel. Her case highlights the need for more medical education about LVT, as quick initiation of anticoagulation is essential in improving outcomes. We review the existing literature to explain the pathogenesis, diagnosis, and treatment of LVT.

摘要

左心室血栓(LVT)是急性心肌梗死(MI)的主要并发症。在此,我们描述一例36岁女性病例,该患者在住院前6年有急性前壁心肌梗死病史,因5.7×1.7 cm左心室血栓导致双侧大脑后动脉(PCA)栓塞性卒中而出现双侧视力丧失。她接受了双侧大脑后动脉取栓术,症状得到改善。她的左心室血栓采用阿哌沙班和氯吡格雷进行非手术治疗。她的病例凸显了对左心室血栓进行更多医学教育的必要性,因为迅速启动抗凝治疗对于改善预后至关重要。我们回顾现有文献以解释左心室血栓的发病机制、诊断和治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f74e/9433785/afeb1c9247f7/cureus-0014-00000027585-i01.jpg

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