Cardiovascular Journal of Africa: Vol 34 No 1 (JANUARY/APRIL 2023)

CARDIOVASCULAR JOURNAL OF AFRICA • Volume 34, No 1, January–April 2023 54 AFRICA of the study, the guidelines will continue to advocate the use of a vitamin K antagonist as standard therapy for this purpose. Conclusion Our case report demonstrates the value of multimodality imaging in the diagnosis and treatment of a large LVT, occurring as a complication of an anterior MI. In addition, with serial monitoring, complete resolution of the thrombus with vitamin K antagonist therapy was demonstrated. Multimodality imaging plays a critical role in the screening for and diagnosis of LVT subsequent to MI, and ultimately this has an impact on treatment and ultimate short- and long-term outcomes. References 1. Driesman A, Hyder O, Lang C, et al. incidence and predictors of left ventricular thrombus after primary percutaneous coronary intervention for anterior ST‐segment elevation myocardial infarction. Clin Cardiol 2015; 38(10): 590–597. 2. Delewi R, Zijlstra F, Piek JJ. Left ventricular thrombus formation after acute myocardial infarction. Heart 2012; 98:1743–1749. 3. You J, Wang X, Wu J, et al. Predictors and prognosis of left ventricular thrombus in post- myocardial infarction patients with left ventricular dysfunction after percutaneous coronary intervention. J Thorac Dis 2018; 10(8): 4912–4922. 4. Garber AM, Mentz RJ, Al-Khalidi HR, et al. Clinical predictors and outcomes of patients with left ventricular thrombus following ST-segment elevation myocardial infarction. J Thromb Thrombol 2016; 41: 365–373. 5. Gianstefani S, Douiri A, Delithanasis I, et al. Incidence and predictors of early left ventricular thrombus after ST-elevation myocardial infarction in the contemporary era of primary percutaneous coronary intervention. Am J Cardiol 2014; 113(7): 1111–1116. 6. Habash F, Vallurupalli S. Challenges in management of left ventricular thrombus. Ther Adv Cardiovasc Dis 2017; 11(8): 203–213. 7. Jugdutt BI, Sivaram CA. Prospective two-dimensional echocardiographic evaluation of left ventricular thrombus and embolism after acute myocardial infarction. J Am Coll Cardiol 1989; 13: 554e64. 8. McCarthy CP, Vuduganathan M, McCarthy KJ, et al. Left ventricular thrombus after acute myocardial infarction: screening, prevention and treatment; J Am Med Assoc Cardiol 2018; 3(7): 642–649. 9. Srichai MB, Junor C, Rodriguez LL, et al. Clinical, imaging, and pathological characteristics of left ventricular thrombus: a comparison of contrast-enhanced magnetic resonance imaging, transthoracic echocardiography, and transesophageal echocardiography with surgical or pathological validation. Am Heart J 2006; 152(1): 75–84. 10. Ram P, Shah M, Patil S, et al. Left ventricular thrombosis in acute anterior myocardial infarction: evaluation of hospital mortality, thromboembolism, and bleeding. Clin Cardiol 2018; 41: 1289–1296. 11. Maniwa N, Fujino M, Nakai M, et al. Anticoagulation combined with antiplatelet therapy in patients with left ventricular thrombus after first acute myocardial infarction. Eur Heart J 2018; 39: 201–208. 12. O’Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines. Circulation 2013; 127(4): 362–425. 13. Ibanez B, James S, Agewall S, et al.; ESC scientific document group. 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the task force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2018; 39(2): 119–177. 14. Seecheran R, Seecheran V, Persad S, Seecheran NA. Rivaroxaban as an antithrombotic agent in a patient with ST-segment elevation myocardial infarction and left ventricular thrombus: a case report. J Investig Med High Impact Case Rep 2017; 5(1): 2324709617697991. 15. Nagamoto Y, Shiomi T, Matsuura T, et al. Resolution of a left ventricular thrombus by the thrombolytic action of dabigatran. Heart Vessels 2014; 29(4): 560–562. 16. US Drug and Food Administration. FDA expands use of Xarelto to treat, reduce recurrence of blood clots. http://www.fda.gov/ NewsEvents. 17. He J, Ge H, Dong JX, et al. Rationale and design of a prospective multi-center randomized trial of EARLY treatment by rivaroxaban versus warfarin in ST-segment elevation MYOcardial infarction with Left Ventricular Thrombus (EARLY-MYO-LVT trial). Ann Transl Med 2020; 8(6): 392.

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