Prevalence and Aetiology of Left Ventricular Thrombus in Patients Undergoing Transthoracic Echocardiography at the University of Maiduguri Teaching Hospital
Objectives. We sought to determine the prevalence and aetiology of LVT among patients undergoing echocardiography. Methods. We reviewed case notes and echocardiographic data of patient diagnosed with LVT using noncontrast transthoracic echocardiography. Definition of various conditions was made using standard guidelines. Mean ± SD were derived for continuous variables and comparison was made using Student’s -test. Results. Total of 1302 transthoracic echocardiograms were performed out of which 949 adult echocardiograms were considered eligible. Mean age of all subjects with abnormal echocardiograms was 44.73 (16.73) years. Abnormalities associated with LVT were observed in 782/949 (82.40%) subjects among whom 84/782 (8.85%) had LVT. The highest prevalence of 39.29% (33/84) was observed in patients with dilated cardiomyopathy, followed by myocardial infarction with a prevalence of 29.76% (25/84). Peripartum cardiomyopathy accounted for 18/84 (21.43%) cases with some having multiple thrombi, whereas hypertensive heart disease was responsible for 6/84 (7.14%) cases. The lowest prevalence of 2.38% (2/84) was observed in those with rheumatic heart disease. Left ventricular EF of <35% was recorded in 55/84 (65.48%). Conclusions. Left ventricular thrombus is common among patients undergoing echo, with dilated cardiomyopathy being the most common underlying aetiology followed by myocardial infarction. Multiple LVTs were documented in peripartum cardiomyopathy. 1. Introduction The development of left ventricular thrombus (LVT) is a well-known complication in various cardiac conditions with the highest rate observed in acute anterior myocardial infarction and congestive heart failure (CHF) as a result of severe left ventricular (LV) systolic dysfunction [1, 2]. The prevalence of LVT, especially in settings where early percutaneous coronary intervention (PCI) facilities are available, is seemingly reducing with estimates ranging between 5% and 15% [2, 3]. Solheim et al., reported an incidence of 15% within 3 months of acute myocardial infarction (AMI) in selected patients managed with primary PCI [4]. However, Rabbani et al. found that the incidence of LVT remains persistently high (35%) in spite of PCI for AMI involving the anterior wall [5]. On the other hand, the occurrence of LVT in cardiomyopathy and CHF ranges from 10 to 30% [6, 7]. The constellation, of endothelial injury, hypercoagulability, and blood stagnation, which are well described previously as Virchow’s triad, is responsible for the formation of thrombus [8, 9]. In AMI, other predisposing factors
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