Summary
Introduction. Left ventricular thrombus is a disease associated with a very high risk of cardiovascular events, embolization, stroke, bleeding, and increased mortality. Traditionally, vitamin K antagonists, predominantly warfarin, have been recommended and used as anticoagulation treatment for left ventricular thrombus. Nowadays, direct oral anticoagulants are increasingly considered as alternatives to vitamin K antagonists.
Case report. We report a case of a 48-year-old man admitted to Vilnius University Hospital Santaros Klinikos due to an ST-segment elevation myocardial infarction. The second echocardiogram during the hospitalization period revealed a left ventricular thrombus. The patient received the direct oral anticoagulant rivaroxaban. As the patient’s general condition improved, he was discharged to the rehabilitation center.
Discussion and conclusions. Scientific articles suggest that direct oral anticoagulants have comparable safety and efficacy outcomes as vitamin K antagonists in terms of thrombus regression, embolization, stroke, bleeding complications, and all-cause mortality. In the latest international guidelines, it is now confirmed that direct oral anticoagulants are an alternative to warfarin for the treatment of left ventricular thrombus.
