СЛУЧАЙ ЭФФЕКТИВНОЙ АНТИКОАГУЛЯНТНОЙ ТЕРАПИИ У БОЛЬНОГО С ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦА, ХРОНИЧЕСКОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТЬЮ, ФИБРИЛЛЯЦИЕЙ ПРЕДСЕРДИЙ И ТРОМБОЗОМ ЛЕВОГО ЖЕЛУДОЧКА

Abstract

Objective: to describe effective treatment in a patient with stent thromboses and a left ventricular (LV) thrombus resistant to therapy with the novel anticoagulants clopidogrel and prasugrel. Materials and methods. Patient P.V., aged 53 years, was admitted to the Department of Cardiology with complaints of dyspnea, lower limb edema, general weakness, palpitation, reduced urine output, and elevated body temperature. His medical history showed myocardial infarction experienced three times, coronary stenting using 3 drug-eluting stents, and stent thromboses. Echocardiography (EchoCG) revealed a mobile thrombus with a total area of 11 cm 2 in the area of chronic LV aneurysm. Results. According to the data of EchoCG conducted over time, there was a decrease in thrombus sizes to 3.06 cm 2 during rivaroxaban therapy, their subsequent increase up to 9.25 cm 2 after anticoagulant therapy that was discontinued without permission, and final lysis of a LV thrombus following the intake of rivaroxaban 20 mg/day during one month. Conclusion. LV thrombus lysis in the rivaroxaban-treated patient with post-infarction cardiosclerosis and stent thromboses resistant to therapy with clopidogrel and prasugrel was described in this case.