田中 一江¹, 宮澤 総介^{1, 2}, 成味 純^{1, 2}, 宮田 晴夫^{1, 2}, 鈴木 厚子², 杉浦 徹², 横井 奈穂子¹, 加藤 まり子¹, 福田 淳¹

Kazue TANAKA¹, Sosuke MIYAZAWA^{1, 2}, Jyun NARUMI^{1, 2}, Haruo MIYATA^{1, 2}, Atsuko SUZUKI², Toru SUGIURA², Naoko YOKOI¹, Mariko KATO¹, Atsushi FUKUDA¹

¹聖隷三方原病院生理検査室 , ²聖隷三方原病院循環器科

¹Department of Clinical Laboratory, Seirei Mikatabara General Hospital, ²Department of Cardiology, Seirei Mikatabara General Hospital

キーワード : Acute myocardial infarction , Echocardiography, Mural thrombus, Pulsed Doppler echocardiography

The first of the two cases discussed here was that of an 80-year-old man admitted because of inferior-wall myocardial infarction. Ultrasonography showed an immobile mural thrombus in the left ventricle. A portion of the thrombus, which was approximately one third the size of the ventricular cavity, was partially protruding. After 8 weeks of warfarin potassium therapy, the thrombus was resolved, leaving no sign of the embolic event. Case 2 was that of a 62-year-old man who had been admitted because of anteroseptal myocardial infarction. An immobile mural thrombus was observed at the left ventricular apex by two-dimensional echocardiography 3 days after admission. The thrombus grew daily until it occupied half of the left ventricular cavity. Antithrombotic therapy decreased its size without embolic episodes, and only a thin, layered thrombus could be seen at the ventricular apex 11 months later. These results suggest that anticoagulant therapy is both safe and effective for resolving immobile left ventricular thrombi with a low incidence of embolization.