Subepicardial aneurysm after anticoagulant therapy for a mural thrombus following anterior myocardial infarction

Abstract

A subepicardial aneurysm became evident in a male patient after anticoagulant therapy. On admission, it appeared to be an old anterior infarction accompanied by a mural thrombus. After warfarin administration, the thrombus disappeared and an echo-free space emerged outside the apical myocardial wall. The echo-free space communicated with the left ventricular cavity through the apical myocardial wall. Emergency surgery was undertaken and the patient survived. The aneurysm was covered with epicardium and there was an endomyocardial rupture of the muscle in the apical wall, which was the entrance of the aneurysm. This case suggests that cautious follow-up with echocardiography is necessary when anticoagulant therapy is selected for thrombi following myocardial infarction.

Fatal biatrial thrombus in a patient with idiopathic restrictive cardiomyopathy during sinus rhythm

“…Thrombus in the cardiac chambers is frequently associated with atrial fibrillation, valvular heart disease, and acute myocardial infarction [1,2]. Patients with an intracardiac thrombus due to restrictive cardiomyopathy are rarely reported in the literature [3,4].…”