Johannessen K A, Nordrehaug J E, von der Lippe G
Br Heart J. 1984 May;51(5):553-6. doi: 10.1136/hrt.51.5.553.
In a prospective study of 90 consecutive patients with acute myocardial infarction, 15 (28.3%) of 53 patients with an anterior wall infarction developed a left ventricular thrombosis diagnosed by cross sectional echocardiography. Patients received anticoagulants only after a left ventricular thrombosis had been diagnosed. Twenty eight patients had an inferior infarction, but none of these had a left ventricular thrombosis. Five (5.5%) of the 90 patients suffered a cerebrovascular accident, and all had an anterior wall infarction. In four of these five patients a left ventricular thrombosis was confirmed by echocardiography before the cerebrovascular accident. All patients with left ventricular thrombosis had apical akinesis. The incidence of a thrombosis did not differ in patients with a first anterior myocardial infarction and with reinfarctions. Among the 40 patients with a first anterior wall infarction, 12 with a thrombosis had a significantly higher incidence of enlarged heart on chest radiographs and significantly higher serum aspartate aminotransferase enzyme activity than those without. Thus patients with a large anterior wall infarction and with akinesis in the apical region are at high risk of developing a left ventricular thrombosis, which may be a source of peripheral emboli. Left ventricular thrombosis appears to be rare with infarctions in other locations.
在一项对90例连续急性心肌梗死患者的前瞻性研究中，53例前壁梗死患者中有15例（28.3%）经横断面超声心动图诊断发生左心室血栓形成。患者仅在诊断出左心室血栓形成后才接受抗凝治疗。28例患者发生下壁梗死，但这些患者均无左心室血栓形成。90例患者中有5例（5.5%）发生脑血管意外，且均为前壁梗死。这5例患者中有4例在脑血管意外发生前经超声心动图证实存在左心室血栓形成。所有左心室血栓形成患者均有心尖运动减弱。首次前壁心肌梗死患者和再梗死患者的血栓形成发生率无差异。在40例首次前壁梗死患者中，12例发生血栓形成者胸部X线片显示心脏增大的发生率显著高于未发生血栓形成者，血清天冬氨酸转氨酶活性也显著更高。因此，前壁大面积梗死且心尖区运动减弱的患者发生左心室血栓形成的风险很高，左心室血栓形成可能是外周栓子的来源。其他部位梗死时左心室血栓形成似乎少见。
