FREQUENCY OF EARLY LEFT VENTRICULAR THROMBUS IN PATIENTS PRESENTING WITH VARIOUS TYPES OF ACUTE ST ELEVATION MYOCARDIAL INFARCTION USING ECHOCARDIOGRAPHY AS A MEASURING TOOL

Abstract

Objectives: To determine frequency of left ventricular thrombus (LVT) in acute ST elevation myocardial
infarction (STEMI) and to find out the correlation of risk factors with development of left ventricular thrombus.
Study Design: Hospital-based observational cross sectional study.
Place and Duration of Study: AFIC/NIHD Rawalpindi, from Nov 2016 to Feb 2017.
Material and Methods: One hundred and fifty consecutive patients presented with first episode of acute STEMI
were included. Patients with previous history of myocardial infarction, valvular heart disease, dilated
Cardiomyopathy and mural thrombus were excluded. 2-D echocardiography was performed after 24 hours, 48
hours and 72 hours of admission. Descriptive and inferential statistical analysis was performed using SPSS
version 23.0.
Results: Mean age of patients was 59.84 ± 11.16 years. Thrombus was seen in 35 (23.3%) patients out of which 21
(60%) were males and 14 (40%) were females. left ventricular thrombus occurred in 8 (22.8%) after 24 hours and
27 (77.2%) patients after 72 hours. LV thrombus was seen in 20 (57.1%) patients whose EF was less than 30% while
it occurred in 10 (28.5%) patients having EF 30-45% and 5 (14.2%) patients with EF >45%. Among risk factor LV
thrombus was seen in 17 (48.5%) diabetic patients, 4 (11.4%) patients had hypertension and 14 (40%) were those
who had both diabetes and hypertension.
Conclusion: LVT is important complication of acute myocardial infarction. If diagnosed and anticoagulated
earlier, risk of complications and its potential to embolise can be minimized.