ISSN: 1859 - 2872
A large left ventricular thrombus resolved with dual antiplatelet therapy in combination with acenocoumarol in a young patient after acute inferior myocardial infarction
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Objective: To present a rare case with thrombus resolved with dual antiplatelet in combination with acenocoumarol. Case presentation: A 35-year-old man with a history of cerebral venous thrombosis was admitted to our hospital for an acute myocardial inferior infarction. He underwent primary percutaneous intervention of the right coronary artery with proximal to distal stent placement. On the next day, bedside echocardiography revealed a huge mobile thrombus in the left ventricle. Cardiac magnetic resonance also imaging confirmed the presence of a large left ventricular thrombus. The Heart Team assessed the case and recommended surgical intervention. However, the patient refused to undergo the surgery. Thus, he received dual antiplatelet therapy with acenocoumarol aimed at achieving a therapeutic international normalized ratio ranging from 2.0 to 3.0. After 2 months of treatment, the left ventricular thrombus disappeared on echocardiography as well as in cardiac magnetic resonance imaging. Conclusion: Our case illustrates that dual antiplatelet and acenocoumarol therapy, within an effective therapeutic range, can have thrombolytic action on a huge acute intracardiac thrombus.
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