Echocardiographic recognition of left ventricular mural thrombus

Left ventricular (LV) mural thrombus is a well recognized complication of a cute myocardial infarction. In survivors of infarction, its incidence is in fluenced by the location, and magnitude of infarction: it occurs often in p atients with large anterior Q wave infarctions, particularly in the presenc e of LV apical akinesis or dyskinesis. Although radionuclide imaging with i ndium-111-labeled platelets, computed tomography, and magnetic resonance im aging may be used to identify LV mural thrombus, two-dimensional echocardio graphy is the technique of choice for assessing its presence, shape, and si ze, and recent technical advances in, echocardiographic methodology, such a s high-frequency, short-focal-length transducers, have improved the echocar diographic assessment of LV mural thrombus. In the patient in whom a mural thrombus is identified, acute and chronic anticoagulation (with heparin and warfarin, respectively) is indicated: first, to prevent further thrombus f ormation and, second, to reduce the incidence of systemic embolization.