IS Case 290: Left ventricular thrombus

Mary Fontanella, MD

Imaging Sciences URMC 2009
Publication Date: 2009-08-05

History

Patient is a 54-year-old female with history of breast and thyroid cancer presenting for metastatic work-up.

Findings

Left ventricular thrombus.

Diagnosis

Left ventricular thrombus.

Discussion

Left ventricular thrombus is seen in the setting of reduced wall motion and is associated with myocardial infarction (MI), cardiomyopathy, and ventricular aneurysm. It is commonly associated with anterior MI, where it occurs in 30-40% of cases, compared to <5% in inferior MI. Fifty-five to 85% of thrombi resolve within 3 years untreated, but the presence of thrombus increases risk for thromboembolic event, and observational studies suggest some benefit in prevention of thromboembolism with warfarin treatment.

References

1. Kontny F, Dale J. Left ventricular thrombus formation and resolution in acute myocardial infarction. Int J Cardiol. 1998 Sep 30;66(2):169-74. PMID: 9829331 [PubMed]