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  • Title: To anticoagulate or not: implications for the management of patients with acute myocardial infarction complicated by both left ventricular thrombus and pericardial effusion.
    Author: Khandheria BK, Shub C, Nishimura RA, Miller FA, Seward JB, Tajik AJ.
    Journal: Can J Cardiol; 1987 May; 3(4):173-6. PubMed ID: 3594300.
    Abstract:
    We reviewed the clinical and echocardiographic characteristics of seven patients with left ventricular thrombus and pericardial effusion. Each patient had a recent anterior wall myocardial infarction with an apical left ventricular thrombus. Two patients had clinical evidence of pericarditis. On two-dimensional echocardiography, the effusion was judged to be small in five cases and moderate in two. All patients received parenteral heparin therapy; six of the seven patients subsequently received long-term oral anticoagulation therapy. None of the patients had any clinical or two-dimensional echocardiographic evidence of increasing pericardial effusion or tamponade. Documented systemic embolization was seen in only one patient, whose anticoagulant therapy was stopped 2 weeks after myocardial infarction. In five patients, repeat two-dimensional echocardiography was performed from 2 to 4 months after infarction; in four patients, neither pericardial effusion nor left ventricular thrombus was found. In this group of patients, both short- and long-term anticoagulants were safely administered despite pericardial effusion.
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