Guidelines

What is atrial mural thrombus?

What is atrial mural thrombus?

Mural thrombi are thrombi that attach to the wall of a blood vessel and cardiac chamber. Mural thrombus occurrence in a normal or minimally atherosclerotic vessel is a rare entity in the absence of a hypercoagulative state or inflammatory, infectious, or familial aortic ailments.

How do you treat a mural thrombus?

Conclusion: Most patients in whom AMT develops in the absence of underlying aortic disease have underlying coagulation disorders. Anticoagulation therapy alone allows resolution of AMT, with surgical intervention reserved for management of end organ ischemia from thrombus embolization.

What causes left ventricular mural thrombus?

Left ventricular (LV) thrombus may develop after acute myocardial infarction (MI) and occurs most often with a large, anterior ST-elevation MI (STEMI). However, the use of reperfusion therapies, including percutaneous coronary intervention and fibrinolysis, has significantly reduced the risk.

Where are mural thrombus found?

Mural thrombi can be seen in large vessels such as the heart and aorta and can restrict blood flow. They are mostly located in the descending aorta, and less commonly, in the aortic arch or the abdominal aorta.

What causes a mural thrombus?

Mural thrombi of the heart most commonly occur from atrial fibrillation, endocarditis, or post-myocardial infarction. Mural thrombi can be treated by acute thrombolysis or by long-term anticoagulation, depending on the clinical scenario.

What are the types of thrombosis?

There are 2 main types of thrombosis:

  • Venous thrombosis is when the blood clot blocks a vein. Veins carry blood from the body back into the heart.
  • Arterial thrombosis is when the blood clot blocks an artery. Arteries carry oxygen-rich blood away from the heart to the body.

Does mural thrombus need treatment?

Background: Thoracic aortic mural thrombus (TAMT) of the descending aorta is rare but can result in dramatic embolic events. Early treatment is therefore crucial; however, there is not a consensus on ideal initial treatment.

What is left atrial thrombus?

The left atrial thrombus is a known complication of atrial fibrillation and rheumatic mitral valve disease, especially in the setting of an enlarged left atrium. If not detected and properly treated, it can lead to devastating thromboembolic complications.

What is the difference between blood clot and thrombosis?

A thrombus is a blood clot that occurs in and occludes a vein while a blood clot forms within an artery or vein and it can break off and travel to the heart or lungs, causing a medical emergency.

What is the difference between thrombus and thrombosis?

Summary. A thrombus is a blood clot, and thrombosis is the formation of a clot that reduces blood flow.

What are the two main types of thrombosis?

When to start anticoagulation therapy for mural thrombus?

But, in practice, many clinicians will start anticoagulation. There is less agreement regarding duration of therapy. Some would treat indefinitely, while others would treat until resolution or until the hypercoagulable cause for the mural thrombus has passed (such as cancer cure).

Where does mural thrombus occur in the heart?

Mural thrombus is formation of thrombus in an artery, most commonly the aorta. Mural thrombi can arise in normal arteries, in the context of hypercoagulability, or within aneurysms. The same term is used to also describe clots in the heart, such as post myocardial infarction in an aneurysmal dilatation.

How is mural thrombus treated in an aortic aneurysm?

If there is an (aortic) aneurysm, the clot is usually removed or excluded as part of aortic aneurysm treatment. If the aneurysm is not at a size that requires treatment, mural thrombus will only be addressed if symptoms occur. The decision is harder when there is no aneurysm. Of course, patients with symptoms will receive treatment.

Can a mural thrombus be diagnosed as an incidental finding?

Mural thrombus may be symptomatic or may be diagnosed as an incidental finding. Incidentally found clot is most often diagnosed on imaging studies performed for other reasons. Computed tomography is the most common imaging to show these findings (as in the images above).