Skip to main content
Erschienen in: Heart and Vessels 4/2014

01.07.2014 | Case Report

Resolution of a left ventricular thrombus by the thrombolytic action of dabigatran

Erschienen in: Heart and Vessels | Ausgabe 4/2014

Einloggen, um Zugang zu erhalten

Abstract

A 77-year-old man was referred to our cardiovascular department for detailed examination after abnormal electrocardiography findings were obtained during a preoperative cataract surgery workup. Ultrasound echocardiography (UCG) and computed tomography (CT) revealed evidence of previous myocardial infarction with anteroseptal akinesis and a left ventricular (LV) thrombus (14 × 12 mm). Dabigatran (220 mg/day) was prescribed as an outpatient treatment, and the disappearance of the LV thrombus was confirmed by UCG and CT 27 days after dabigatran initiation. No thromboembolism occurred between treatment initiation and thrombus resolution. Our results indicate that dabigatran has thrombolytic action on an acute pre-existing intracardiac thrombus.
Literatur
1.
Zurück zum Zitat Fuster V, Ryden LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, Halperin JL, Kay GN, Le Huezey JY, Lowe JE, Olsson SB, Prystowsky EN, Tamargo JL, Wann LS (2011) 2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 Guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. J Am Coll Cardiol 57:e101–e198PubMedCrossRef Fuster V, Ryden LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, Halperin JL, Kay GN, Le Huezey JY, Lowe JE, Olsson SB, Prystowsky EN, Tamargo JL, Wann LS (2011) 2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 Guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. J Am Coll Cardiol 57:e101–e198PubMedCrossRef
2.
Zurück zum Zitat Schulman S, Kearon C, Kakkar AK, Mismetti P, Schellong S, Eriksson H, Baanstra D, Schnee J, Goldhaber SZ (2009) Dabigatran versus warfarin in the treatment of acute venous thromboembolism. N Engl J Med 361:2342–2352PubMedCrossRef Schulman S, Kearon C, Kakkar AK, Mismetti P, Schellong S, Eriksson H, Baanstra D, Schnee J, Goldhaber SZ (2009) Dabigatran versus warfarin in the treatment of acute venous thromboembolism. N Engl J Med 361:2342–2352PubMedCrossRef
3.
Zurück zum Zitat Lee CH, Chen CC, Chern MS (2007) Thrombolytic therapy for acute left atrial thrombus formation in one patient with heart failure and atrial fibrillation. Circ J Off J Jpn Circ Soc 71:604–607 Lee CH, Chen CC, Chern MS (2007) Thrombolytic therapy for acute left atrial thrombus formation in one patient with heart failure and atrial fibrillation. Circ J Off J Jpn Circ Soc 71:604–607
4.
Zurück zum Zitat Marcu CB, Kramer C, Donohue TJ (2007) Giant left atrial thrombus successfully treated with anticoagulation. Heart Lung Circ 16:55–56PubMedCrossRef Marcu CB, Kramer C, Donohue TJ (2007) Giant left atrial thrombus successfully treated with anticoagulation. Heart Lung Circ 16:55–56PubMedCrossRef
5.
Zurück zum Zitat Yasaka M, Yamaguchi T, Miyashita T, Tsuchiya T (1990) Regression of intracardiac thrombus after embolic stroke. Stroke 21:1540–1544PubMedCrossRef Yasaka M, Yamaguchi T, Miyashita T, Tsuchiya T (1990) Regression of intracardiac thrombus after embolic stroke. Stroke 21:1540–1544PubMedCrossRef
6.
Zurück zum Zitat Siebelink HM, Scholte AJ, Van de Veire NR, Holman ER, Nucifora G, van der Wall EE, Bax JJ (2009) Value of contrast echocardiography for left ventricular thrombus detection postinfarction and impact on antithrombotic therapy. Coron Artery Dis 20:462–466PubMedCrossRef Siebelink HM, Scholte AJ, Van de Veire NR, Holman ER, Nucifora G, van der Wall EE, Bax JJ (2009) Value of contrast echocardiography for left ventricular thrombus detection postinfarction and impact on antithrombotic therapy. Coron Artery Dis 20:462–466PubMedCrossRef
7.
Zurück zum Zitat Choi SH, Jeong SI, Yang JH, Kang IS, Jun TG, Lee HJ, Huh J (2010) A single-center experience with intracardiac thrombosis in children with dilated cardiomyopathy. Pediatr Cardiol 31:264–269PubMedCrossRef Choi SH, Jeong SI, Yang JH, Kang IS, Jun TG, Lee HJ, Huh J (2010) A single-center experience with intracardiac thrombosis in children with dilated cardiomyopathy. Pediatr Cardiol 31:264–269PubMedCrossRef
8.
Zurück zum Zitat Ellis K, Ziada KM, Vivekananthan D, Latif AA, Shaaraoui M, Martin D, Grimm RA (2006) Transthoracic echocardiographic predictors of left atrial appendage thrombus. Am J Cardiol 97:421–425PubMedCrossRef Ellis K, Ziada KM, Vivekananthan D, Latif AA, Shaaraoui M, Martin D, Grimm RA (2006) Transthoracic echocardiographic predictors of left atrial appendage thrombus. Am J Cardiol 97:421–425PubMedCrossRef
9.
Zurück zum Zitat Stoddard MF, Singh P, Dawn B, Longaker RA (2003) Left atrial thrombus predicts transient ischemic attack in patients with atrial fibrillation. Am Heart J 145:676–682PubMedCrossRef Stoddard MF, Singh P, Dawn B, Longaker RA (2003) Left atrial thrombus predicts transient ischemic attack in patients with atrial fibrillation. Am Heart J 145:676–682PubMedCrossRef
10.
Zurück zum Zitat Tsai LM, Lin LJ, Teng JK, Chen JH (1997) Prevalence and clinical significance of left atrial thrombus in nonrheumatic atrial fibrillation. Int J Cardiol 58:163–169PubMedCrossRef Tsai LM, Lin LJ, Teng JK, Chen JH (1997) Prevalence and clinical significance of left atrial thrombus in nonrheumatic atrial fibrillation. Int J Cardiol 58:163–169PubMedCrossRef
11.
Zurück zum Zitat Leung DY, Davidson PM, Cranney GB, Walsh WF (1997) Thromboembolic risks of left atrial thrombus detected by transesophageal echocardiogram. Am J Cardiol 79:626–629PubMedCrossRef Leung DY, Davidson PM, Cranney GB, Walsh WF (1997) Thromboembolic risks of left atrial thrombus detected by transesophageal echocardiogram. Am J Cardiol 79:626–629PubMedCrossRef
12.
Zurück zum Zitat Wada H, Yasu T, Sakakura K, Hayakawa Y, Ishida T, Kobayashi N, Kubo N, Ako J, Momomura SI (2013) Contrast echocardiography for the diagnosis of left ventricular thrombus in anterior myocardial infarction. Heart Vessels. doi:10.1007/s00380-013-0363-9 Wada H, Yasu T, Sakakura K, Hayakawa Y, Ishida T, Kobayashi N, Kubo N, Ako J, Momomura SI (2013) Contrast echocardiography for the diagnosis of left ventricular thrombus in anterior myocardial infarction. Heart Vessels. doi:10.​1007/​s00380-013-0363-9
13.
Zurück zum Zitat Aboukhoudir F, Rekik S, Hirsch JL (2009) Images in cardiovascular medicine. Live echocardiographic visualization of the migration of a voluminous left ventricular thrombus complicating an acute myocarditis. Circulation 120:e8–e10PubMedCrossRef Aboukhoudir F, Rekik S, Hirsch JL (2009) Images in cardiovascular medicine. Live echocardiographic visualization of the migration of a voluminous left ventricular thrombus complicating an acute myocarditis. Circulation 120:e8–e10PubMedCrossRef
14.
Zurück zum Zitat Fujiwara M, Watanabe H, Oguma Y, Yamaura G, Ishibashi K, Yamamoto H, Nobori K, Iino K, Yamamoto F, Ito H (2012) A free-floating left atrial thrombus develops intermittent entrapment in the mid-ventricle during diastole. Heart Vessels 27:428–431PubMedCrossRef Fujiwara M, Watanabe H, Oguma Y, Yamaura G, Ishibashi K, Yamamoto H, Nobori K, Iino K, Yamamoto F, Ito H (2012) A free-floating left atrial thrombus develops intermittent entrapment in the mid-ventricle during diastole. Heart Vessels 27:428–431PubMedCrossRef
15.
Zurück zum Zitat Feinberg WM, Bruck DC, Ring ME, Corrigan JJ (1989) Hemostatic markers in acute stroke. Stroke 20:592–597PubMedCrossRef Feinberg WM, Bruck DC, Ring ME, Corrigan JJ (1989) Hemostatic markers in acute stroke. Stroke 20:592–597PubMedCrossRef
16.
Zurück zum Zitat van Ryn J. K-EM, Kuritsch I, Wienen W. (2009) Effects of direct thrombin or factor Xa inhibition on clot thrombogenicity in vitro: comparison of dabigatran with rivaroxaban and apixaban. J Thromb Haemost 7 (Suppl 2):Abst:PP-WE-181 van Ryn J. K-EM, Kuritsch I, Wienen W. (2009) Effects of direct thrombin or factor Xa inhibition on clot thrombogenicity in vitro: comparison of dabigatran with rivaroxaban and apixaban. J Thromb Haemost 7 (Suppl 2):Abst:PP-WE-181
17.
Zurück zum Zitat Niemann M, Gaudron PD, Bijnens B, Stork S, Beer M, Hillenbrand H, Cikes M, Herrmann S, Hu K, Ertl G, Weidemann F (2012) Differentiation between fresh and old left ventricular thrombi by deformation imaging. Circ Cardiovasc Imaging 5:667–675PubMedCrossRef Niemann M, Gaudron PD, Bijnens B, Stork S, Beer M, Hillenbrand H, Cikes M, Herrmann S, Hu K, Ertl G, Weidemann F (2012) Differentiation between fresh and old left ventricular thrombi by deformation imaging. Circ Cardiovasc Imaging 5:667–675PubMedCrossRef
Metadaten
Titel
Resolution of a left ventricular thrombus by the thrombolytic action of dabigatran
Publikationsdatum
01.07.2014
Erschienen in
Heart and Vessels / Ausgabe 4/2014
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-013-0403-5

Weitere Artikel der Ausgabe 4/2014

Heart and Vessels 4/2014 Zur Ausgabe

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Adipositas-Medikament auch gegen Schlafapnoe wirksam

24.04.2024 Adipositas Nachrichten

Der als Antidiabetikum sowie zum Gewichtsmanagement zugelassene Wirkstoff Tirzepatid hat in Studien bei adipösen Patienten auch schlafbezogene Atmungsstörungen deutlich reduziert, informiert der Hersteller in einer Vorab-Meldung zum Studienausgang.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.