Myocardial deformation in diagnosis of post-infarction thrombi of the left ventricle

Myocardial infarction remains one of the leading causes of high cardiovascular mortality in Russia and in the world. Formation of aneurysm of the left ventricle (LV) and parietal thrombus is a common complication of this incident. Thrombus in the LV cavity is a threat for the development of thromboembolic syndrome that requires appointment of long-term therapy with indirect anticoagulants, which on the other hand are dangerous for the development of severe haemorrhagic complications. The risk of bleeding in such cases may increase simultaneously with the decrease ischemic stroke risk. The appointment and cancellation of indirect anticoagulants should, therefore, be done according to strict indications, however, traditional sero-scale echocardiography does not always make it possible to confirm or refute the diagnosis of thrombosis confidently. The “golden standard” for diagnosing LV thrombosis is magnetic resonance imaging (MRI). However, this technique is of high cost and is available only in highly specialized institutions, therefore, its implementation remains impossible in all situations difficult from the point of view of diagnosis. In doubtful cases, the use of ultra-sound technique “speckle tracking imaging” can help to avoid MRI appointment, showing the presence or absence of myocardial contractile tissue.