INCIDENCE, PREDICTORS AND COURSE OF LEFT VENTRICULAR THROMBUS IN INDIAN PATIENTS SURVIVING TO DISCHARGE AFTER ANTERIOR WALL MYOCARDIAL INFARCTION
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2019, Vol 6, Issue 15
Abstract
BACKGROUND To prospectively estimate the incidence of left ventricular (LV) thrombus over one-year follow-up in patients presenting with anterior wall myocardial infarction (AWMI) and to identify the predictors of LV thrombus, to study the course of LV thrombus including clinically evident thrombo-embolic manifestations over a one-year period in Indian population. METHODS Two hundred patients with first AWMI were prospectively and consecutively enrolled. At the time of hospitalization, key demographic and clinical characteristics were collected along with echocardiographic data. Patients were followed up for development or change in existing LV thrombus and thromboembolic event. RESULTS Incidence of LV thrombus was 6.5%. The mean platelet volume and LV wall motion score index (LVWMSI) were significantly higher in LV thrombus patients in comparison to non-LV thrombus patients. Baseline ejection fraction (EF), mean mitral E wave deceleration time (MDT) and mean mitral propagation velocity (MVP) were significantly lower in LV thrombus patients. At oneyear follow-up, 30.76% patients showed disappearance of thrombus, 46.15% showed decrease in size and 23.07% showed no change in size while 15.38% patients showed embolic events. CONCLUSIONS High MPV at admission, low baseline EF, high LVWMSI, low baseline MDT and low MVP are independent predictors of LV thrombus. Moreover, patients undergoing primary PTCA have decreased risk of LV thrombus.
Authors and Affiliations
Sajeev Chakanalil Govindan, Ankur Kamra, Haridasan Vellani
ULCERATIVE KERATITIS A PROSPECTIVE HOSPITAL BASED CLINICAL AND MICROBIOLOGICAL STUDY
A total of 150 patients with clinical diagnosis of ulcerative keratitis with or without hypopyon were enrolled in this study. A maximum of patients were from age group 21 to 40 years followed by patients in the age group...
A STUDY OF CLINICAL PROFILE OF PATIENTS WHO PRESENTED WITH FEVER DURING THE MONTHS OF JUNE 2017 TO JANUARY 2018
BACKGROUND Fever is defined as temperature above 37.2oC @ 6 AM and temperature recording above 37.7 C @ 6 PM. Malaria is caused by 5 species of Plasmodium (P.falciparum, P.ovale, P.malariae, P.kowlesi and P.vivax). It is...
STUDY OF PLATELET COUNT-SPLEEN DIAMETER RATIO AS A NON-INVASIVE PREDICTOR OF OESOPHAGEAL VARICES IN PATIENTS WITH CIRRHOSIS OF LIVER
BACKGROUND Most cirrhotic patients will develop oesophageal varices over their lifetime and the annual rate of oesophageal haemorrhage is 5 to 15%. Current guidelines recommend using Upper Gastrointestinal Endoscopy (UGI...
COMPARISON OF BEHAVIOURAL PROBLEMS AMONG CHILDREN OF WORKING AND NONWORKING WOMEN
BACKGROUND It stresses that the mother’s reaction plays an important role in moulding the behaviour of a child. Mothering styles affect the behaviour of the children and less time spent with children can lead to abnormal...
TREATMENT OF DISPLACED MID SHAFT CLAVICULAR FRACTURES WITH OPEN REDUCTION AND INTERNAL FIXATION WITH PLATE AND SCREWS
BACKGROUND Midshaft clavicular fractures are most common fractures encountered. Treatment of choice was conservative whether comminuted or displaced. Figure-of-eight bandage was used in treating all these fractures. Many...