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Comment & Response
October 3, 2018

Optimizing the Detection of Left Ventricular Thrombus Following Acute Myocardial Infarction in the Current Era—Reply

Author Affiliations
  • 1Department of Medicine, Massachusetts General Hospital, Boston
  • 2Brigham and Women’s Hospital Heart and Vascular Center, Harvard Medical School, Boston, Massachusetts
  • 3Johns Hopkins Coronary Care Unit, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
JAMA Cardiol. Published online October 3, 2018. doi:10.1001/jamacardio.2018.3142

In Reply Several uncertainties currently exist regarding the detection and management of left ventricular (LV) thrombus after acute myocardial infarction (MI). One such ambiguity is the timing at which screening should be performed for LV thrombus detection after MI. We recently suggested that transthoracic echocardiogram (TTE) should be performed within 24 hours of admission in patients at high risk for apical LV thrombus (eg, those with large or anterior MI or those receiving delayed reperfusion).1 Furthermore, in high-risk patients without LV thrombus on initial imaging, one approach to surveillance may involve repeated imaging with a TTE or cardiac magnetic resonance imaging (CMR) at 1 to 3 months post-MI.1

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