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mechanical valve thrombosis; prosthetic valve thrombosis
Etiology:
- insufficient anticoagulation (low INR)
- risk factors for thrombosis
- oral contraceptives
Epidemiology:
- annual risk 0.3-1.3%, higher with subtherapeutic INR
Clinical manifestations:
- prosthetic aortic valve thrombosis:
- muffled aortic valve click
- combined systolic murmur & diastolic murmur may be present
- prosthetic mitral valve thrombosis:
- soft S1
- combined systolic murmur & diastolic murmur may be present
- pulmonary edema, jugular venous distension, respiratory failure
Special laboratory:
- echocardiography
Complications:
- mechanical valve thrombosis can interfere with prosthetic leaflet movement & result in acute heart failure
- embolism of the thrombus may occur leading to embolic stroke or infarcts in other end-organs
General
thrombosis
References
- Roudaut R, Serri K, Lafitte S.
Thrombosis of prosthetic heart valves: diagnosis and therapeutic considerations
Heart. 2007 Jan;93(1):137-42
PMID: 17170355 PMCID: PMC1861363 Free PMC article
- Harris KC, Campbell AI.
Images in clinical medicine. Thrombosis of a mechanical mitral valve.
N Engl J Med. 2011 Dec 15;365(24):e45.
PMID: 22168664 Free article.