Left Ventricular Thrombi Identified by Cross-Sectional Echocardiography

Abstract

Patients (25) with anterior myocardial infarction and 2 with congestive cardiomyopathy were studied to evaluate 2-dimensional echocardiography in diagnosing left ventricular thrombi. Coronary patients (5) had systemic emboli. Of these patients, 4 manifested apical filling defects on cineangiograms and a levophase cine was equivocal for clot in the 5th patient. Neither echocardiography nor cineangiography visualized ventricular thrombi in the nonembolus coronary patients. Echoes from a distinct apical mass were visualized in all 5 patients in the embolus group by 2-dimensional echocardiography at the cardiac apex. Apical thrombi were confirmed in all 4 patients in the embolus group undergoing surgery. The irregular configuration of recent thrombi in the coronary patients differed from the circumscribed appearance of chronic thrombi in cardiomyopathy patients on 2-dimensional echocardiograms. Two-dimensional echocardiography can be used to detect and characterize left ventricular thrombi.