Conservative Management of Left Ventricular Thrombus Patient with Decreased Systolic Function: A Case Report

I. Kadek, Herry Hermawan, Ken Christian Kawilarang, F. Hartono
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Abstract

Highlights: It provides insight into the management of LVT. Abstract: Case Summary. A 35-year-old male complained shortness of breath for 1 month, had worsened in the last 3 days. When walking 3-5 steps, the patient already felt dyspneu. When sleeping, the patient must be in a semi-sitting position, and sometimes still feels tight. The patient also complained of occasional chest pain. The patient is known to have a history of heart disease, and a history of taking drugs such as candesartan, ISDN and bisoprolol. Discussion. Left ventricular thrombus (LVT) is a frequent and potentially dangerous complication of acute myocardial infarction and is associated with increased risk of systemic embolization. Incidence of LVT following acute MI has decreased, probably due to improvement in patient care as a result of better and earlier reperfusion techniques. Management of LVT is primarily based on studies before the widespread use of potent pharmacological and interventional therapies such as primary percutaneous coronary intervention, especially in the setting of acute myocardial infarction. Though advances in diagnostic technology have improved detection of LVT, clinicians face several uncertainties in the management of LVT in daily practice.
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左心室血栓合并收缩功能下降的保守治疗1例
亮点:对LVT的管理提供了深入的见解。文摘:总结。男,35岁,主诉呼吸短促1个月,近3天加重。行走3-5步时,患者已感到呼吸困难。睡觉时,患者必须呈半坐位,有时仍感觉紧绷。病人还说偶尔胸痛。已知患者有心脏病史,有坎地沙坦、ISDN、比索洛尔等药物服用史。讨论。左室血栓(LVT)是急性心肌梗死的一种常见且潜在危险的并发症,与全身栓塞的风险增加有关。急性心肌梗死后LVT的发生率有所下降,这可能是由于更好和更早的再灌注技术改善了患者护理。LVT的管理主要是基于在广泛使用有效的药物和介入治疗(如原发性经皮冠状动脉介入治疗)之前的研究,特别是在急性心肌梗死的情况下。尽管诊断技术的进步提高了LVT的检测水平,但临床医生在日常治疗中仍面临着一些不确定因素。
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