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[心肌梗死后左心室血栓形成的超声心动图检测与随访]

[Echocardiographic detection and follow up of left ventricular thrombosis following myocardial infarct].

作者信息

Rusznák M

机构信息

Jósa András Kórház-Rendelöintézet Nyíregyháza, III. sz. Belgyógyászati Osztály/Kardiológia.

出版信息

Orv Hetil. 1993 Jan 3;134(1):11-4.

PMID:8418442
Abstract

914 patients with myocardial infarction have been examined during the last 3 years. Left ventricular thrombi were found in 74 patients (8%), (58 male and 16 female, median age 57.3 years). Thrombi were found in 37 cases, oval protruding in 28 cases, pedicled or multiple in 9 cases. Thrombus was most frequently located to the apex (61 cases), while in 8 patients localization was anteroseptal, in 4 patients anterolateral and in 1 patient inferior. 36 patients had also ventricular aneurysm of which 23 were at the apex and 13 at the anterior wall. After anticoagulant therapy the patients were controlled by echocardiography. In 23 out of the 53 patients that were restudied the thrombus had resolved, in 8 patients thrombus has decreased in size and in 22 patients there was no change in thrombus size. Embolism has occurred in 13 cases of which 10 were cerebral embolism. During the follow-up period (mean 12.8 months) six patients died. On the basis of their study the authors conclude that thrombosis is a frequent complication of anterior myocardial infarction and may lead to embolic events, so anticoagulant therapy controlled by echocardiography is needed, because of it's efficacy in the resolution of thrombus and eliminating the risk of embolism.

摘要

在过去3年中,对914例心肌梗死患者进行了检查。74例(8%)患者发现左心室血栓(58例男性,16例女性,中位年龄57.3岁)。37例发现血栓,28例呈椭圆形突出,9例有蒂或多发。血栓最常位于心尖(61例),8例位于前间隔,4例位于前外侧,1例位于下壁。36例患者还患有室壁瘤,其中23例位于心尖,13例位于前壁。抗凝治疗后,通过超声心动图对患者进行监测。在重新检查的53例患者中,23例血栓溶解,8例血栓缩小,22例血栓大小无变化。13例发生栓塞,其中10例为脑栓塞。在随访期(平均12.8个月)内,6例患者死亡。基于他们的研究,作者得出结论,血栓形成是前壁心肌梗死的常见并发症,可能导致栓塞事件,因此需要通过超声心动图监测进行抗凝治疗,因为其在溶解血栓和消除栓塞风险方面具有疗效。

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