Clinical characteristics of patients with fresh left ventricular thrombus

The present study analyzed the clinical backgrounds of 9 patients with fres h left ventricular thrombus (LVT) detected by two-dimensional echocardiogra phy during the past 5 years. Patients with acute myocardial infarction were excluded. Left ventricular systolic function was disturbed either diffusel y or segmentally in all patients with a mean ejection fraction of 33%. In 7 patients, echocardiography was performed shortly after furosemide therapy for New York Heart Association class IV congestive heart failure; echocardi ography was also performed just before treatment in 4 of the 7 patients and LVT was not detected in any of them. Two patients died of underlying disor ders within 2 months of detection of the thrombus. However, the LVT disappe ared in the other 7 patients without any thromboembolic episodes during the 6 months after starting anticoagulant therapy. As fresh LVT developed shor tly after diuretic therapy in patients with severe congestive heart failure associated with left ventricular systolic dysfunction, concomitant anticoa gulant therapy is recommended.