WHO'S THE REAL CULPRIT, HYPEREOSINOPHILIA OR CORONARY ARTERY DISEASE? A CASE REPORT OF THROMBOEMBOLIC EVENTS IN A LEFT VENTRICULAR THROMBUS.

Left ventricular thrombosis (LVT) is a significant issue resulting from ischemia and non-ischemic cardiomyopathy. Despite a decrease in prevalence due to reperfusion therapy, it remains a significant concern. Diagnosis is often based on transthoracic echocardiography, but it may yield inconclusive results. Advanced imaging, like cardiac magnetic resonance, is needed to accurately characterize intraventricular masses. The formation of LV thrombus is associated with a 5.5-fold increased risk of thromboembolic events compared with no thrombus (1). Without anticoagulation, the annual stroke or systemic embolization rate is approximately 10% to 15% per year. The clinical outcomes vary based on the locations of embolization. Since these thromboembolic events are generally sudden and unpredictable.

Vitamin K antagonists are traditionally used for treating LVT, but recent guidelines classify direct oral anticoagulants (DOACs) with the same level of evidence as vitamin K antagonists (VKAs) and recommend an individualized approach for both prevention strategies and treatment duration with regard to the therapeutic strategy for LVT.

Attention should be paid to the risk of bleeding. The choice of anticoagulation regimen should be tailored to the individual patient.