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Left Ventricular Thrombus
Acknowledgments
The authors acknowledge the contributions of Drs. Amr E. Abbas, MD, and Steven J. Lester, MD, who were the authors of this chapter in the previous edition.
Left Ventricular Thrombus With Impaired Left Ventricular Function
Thrombus formation within the left ventricle can be noted 24 hours after an acute myocardial infarction (AMI); 90% of the time they are formed within 2 weeks following the event, but they can form within the first 3 months ( Fig. 126.1 ). The incidence of LV thrombus after an AMI has been reported to be between 7% and 46%, depending on the diagnostic modality used for detection. However, contemporary literature reports a declining incidence of left ventricular (LV) thrombus after AMI, mainly attributed to the growing use of primary percutaneous coronary intervention (PCI), which varies between 5% and 15% in patients receiving percutaneous treatment. LV thrombus usually occurs after AMI in the left anterior descending artery (LAD) territory being less common after infarction in non-LAD territories. About 11% of clots may occur in the septal wall, and 3% occur in the inferior wall ( Fig. 126.2 and 
), particularly when the infarct extends to the lateral wall.
BOX 126.1
Predisposing Conditions for Left Ventricular Thrombus Formation
LAD, Left anterior descending coronary artery; LV, left ventricular; MI, myocardial infarction.
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