ТРОМБОЗ ЛЕВОГО ЖЕЛУДОЧКА В КЛИНИЧЕСКОЙ ПРАКТИКЕ

Abstract

Left ventricular thrombosis is a potentially life-threatening condition due to a significant risk of stroke and systemic thromboembolism. Despite the more frequent use of primary percutaneous coronary interventions and dual antiplatelet therapy in clinical practice the majority of left ventricular thrombus are diagnosed after myocardial infarction, although such a complication can occur both in ischaemic and non-ischaemic cardiomyopathies. The article provides information on left ventricular thrombosis in internal diseases according to current concepts. The authors characterize risk factors and pathophysiological mechanisms in thrombosis, the predictors of embolic events. Modern imaging methods for diagnosis of left ventricular thrombosis are described. The article outlines that cardiac magnetic resonance has the highest diagnostic accuracy, followed by echocardiography with the use of echocardiographic contrast agents. Particular attention is paid to the treatment with vitamin K antagonists and direct oral anticoagulants. There is growing evidence of the benefits of direct acting oral anticoagulants in treatment of left ventricular thrombosis. It is expected that ongoing clinical trials will help elucidate the best management strategies for these patients.