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Dilated cardiomyopathy and thrombo-embolism |
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| Authors: | J Günthard F Stocker D Bolz E Jäggi R Ghisla I Oberhänsli F Wyler |
| Institution: | Postfach, R?mergasse 8, Tel.: 61 861 18 00 (P), Tel.: 61 691 26 26 (B), Fax: 61 692 65 55 (B), CH-4005 Basel, Switzerland, CH University Children's Hospital, Barno, Switzerland, University Children's Hospital, Barno, CH University Children's Hospital, Zürich, Switzerland, University Children's Hospital, Zürich, CH University Children's Hospital, Geneva, Switzerland, University Children's Hospital, Geneva, CH University Children's Hospital, St. Gallen, Switzerland, University Children's Hospital, St. Gallen, CH |
| Abstract: | The purpose of this study was to investigate the incidence, outcome and prevention of thrombo-embolism in children with dilated cardiomyopathy. From 130 patients with dilated cardiomyopathy, 17 (14%) showed evidence of thrombo-embolism. Seven had initial cardiac thrombus, 7 exhibited initial embolus and in 3 thrombo-embolism was only diagnosed at autopsy. All 17 patients showed seriously impaired systolic function of the left ventricle with fractional shortening (FS) of 10?±?3%, range 5%–17%, as compared to those without thrombo-embolism with FS of 17%?±?6%, range 5%–26% (P?<;?0.0001). Seven patients were treated with oral anticoagulants once thrombo-embolism had been diagnosed; one of them experienced a further embolic event as opposed to three out of four patients not treated with anticoagulants. Conclusion?All children with dilated cardiomyopathy and fractional shortening below 20% should be treated with prophylactic anticoagulative agents |
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