Patient selection: following major surgery
Risk factors for a left ventricular thrombus:
(1) cardiomyopathy (ischemic, dilated, other)
(2) acute myocardial infarction
(3) other low flow condition
(4) hypercoagulable state
(5) central venous catheter
(6) absence of anticoagulation
Features seen on echocardiography:
(1) located at the cardiac apex
(2) associated with akinetic or dyskinetic cardiac wall
(3) soft and uncalcified
(4) pedunculated
(5) mobile
The left ventricle is examined using:
(1) the apical 4-chamber view
(2) scanning the apex in the short-axis parasternal view
Additional technical points:
(1) A thin, fixed mural thrombus can be missed.
(2) Poor technical quality or limited experience can reduce detection.
(3) Contrast agents can improve detection of borderline lesions.
