Hit Two Birds With One Stone Via Thrombolytic Treatment

Abstract

Early data showed that in the setting of acute myocardial infarction (AMI), left ventricular thrombus (LVT) was present in most frequently in acute apical or anterior AMI. There are several studies on the frequency of LVT formation in patients treated with precurtain coronary intervention (PCI). Solheim et al. reported LVT incidence of 15% in the first 3 months in AMI patients who were treated with primary PCI. In a meta-analysis it was shown that LVT is an important problem especially among patients with anterior AMI and management strategy is a point of interest. The incidence of LVT is in a decline recently. According to the current guidelines, immediate revascularisation of infarct related artery, use of sufficient anticoagulant therapy and agents that improve remodelling of the left ventricle was associated with decrease in incidence of LVT. Although the use of ACE-inhibitors had a favourable effect on left ventricle remodelling, there were no differences in LVT formation between those patients on ACE-inhibitor therapy and those who were not. LVT formation is associated with the infarct region, more frequent in anterior AMI, extent of infarct area and presence of aneurysm. In this case report we present a patient applied to the hospital with neurologic symptoms and diagnosed with acute ischemic stroke possibly due to left ventricle thrombus, possibly developed after the anterior MI 20 days ago. By thrombolytic therapy cardiac thrombus was dissolved and after 7 days the patient had complete neurologic recovery.