Cheng T C
Postgrad Med. 1982 Oct;72(4):135-8, 142. doi: 10.1080/00325481.1982.11716219.
A 65-year-old woman was hospitalized several times after having an acute anteroseptal transmural infarction. Her course was complicated by recurrent ventricular tachycardia and severe left ventricular failure. Chest x-ray films showed pulmonary congestion and mild right pleural effusion. Two-dimensional echocardiography revealed a large left ventricular thrombus, which resolved after two months of treatment. The course of anticoagulation was later complicated by massive gastrointestinal hemorrhage. Finally, the patient died in her sleep, probably as a result of arrhythmia. An autopsy revealed extensive left ventricular mural thrombi. The early identification of left ventricular thrombus by two-dimensional echocardiography has lifesaving implications. It is possible that, with proper medical management, further formation of pulmonary emboli could be prevented.
一名65岁女性在发生急性前壁透壁性心肌梗死后多次住院。她的病程因反复发作的室性心动过速和严重的左心室衰竭而复杂化。胸部X光片显示肺淤血和轻度右侧胸腔积液。二维超声心动图显示左心室有一个大血栓，经过两个月的治疗后消失。抗凝治疗过程后来因大量胃肠道出血而复杂化。最后，患者在睡眠中死亡，可能是心律失常所致。尸检发现左心室有广泛的壁血栓。二维超声心动图早期识别左心室血栓具有挽救生命的意义。通过适当的医疗管理，有可能预防肺栓塞的进一步形成。
