11. Predictors of Left Atrial Thrombus in Patients with Severe Mitral Stenosis
Imran Javaid1, Muhammad Zafar Iqbal2, Abrar Ahmad3 and Faizan Mustafa1
ABSTRACT
Objective: To evaluate the trans esophageal echocardiography (TEE) findings in patients of mitral stenosis and to determine the risk factors associated with Left atrial (LA) thrombus in this disease.
Study Design: Prospective study
Place and Duration of Study: This study was conducted at the Medicine & Cardiology/CCU DG Khan Medical College & Teaching Hospital, DG Khan from May 2019 to April 2020 in one year duration.
Materials and Methods: A total of hundred patients selected in this study. Patients aged 15 or above with any gender having severe mitral stenosis eligible for percutaneous trans venous mitral commissurotomy (PTMC) on the basis of trans esophageal echocardiography (TEE) were selected for this study. SPSS version 23 was used for data analysis. Test of significant were applied and p value ≥0.05 was taken as significant.
Results: Considering demographics, the mean age of the patients was 33.4±16.56 years and majority of females 89% in our study. LA thrombus formation was cross tabulated against 7 clinical and echocardiographic parameters and their association with LA clot formation was evaluated with Pearson chi square test. These variables were Age, Atrial fibrillation, mitral valve area, mitral regurgitation, Wilkins score, pulmonary hypertension and LA size. Out of these parameters; atrial fibrillation, Wilkin’s score, LA size and pulmonary hypertension were significantly associated with LA clot formation with asymptotic significance of 0.000, 0.000, 0.007 and 0.034 respectively.
Conclusion: Rheumatic Mitral stenosis is a major public health concern in our country. Management of these patients is complicated by LA thrombus and systemic embolism. This study showed presence of AF, enlarged LA, severe pulmonary hypertension and high Wilkin’s score to be the predictor of LA thrombus.
Key Words: Rheumatic heart disease (RHD), Left atrial thrombus, Mitral stenosis, Transesophageal echocardiography
Citation of article: Javaid I, Iqbal MZ, Ahmad A, Mustafa F. Predictors of Left Atrial Thrombus in Patients with Severe Mitral Stenosis, Med Forum 2021;32(6):42-46.