Conclusive remarks
Current echocardiographic-guided screening and management strategies for
LVT in patients with recent anterior MI warrant to be re-evaluated in
light of the advances in technology which greatly improve the diagnostic
accuracy of this approach as compared to CE-CMR. However, this pathway
relied on resolution on TTE as evidence of treatment effect requires
prospective validation since many questions, such as the prognostic
significance of LVT detected by CE-CMR but not by contrast TTE, are
still unanswered. In some cases, a LVT can be a marker of an increased
thrombotic risk that persists at the long term, after the initial period
of anticoagulation and even despite thrombus resolution by TTE. This
knowledge could guide the selection of the optimal imaging modality for
the screening of patients with recent anterior MI at high risk for LVT.
Hopefully, this work might strengthen the role of echocardiography in
the management of these patients.