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This scientific statement suggests that CMR may be most appropriate when: a) there is the suggestion of a possible LV thrombus on echocardiogram but echocardiography imaging even with an ultrasound-enhancing agent is not diagnostic, and b) echocardiography does not demonstrate LV thrombus but a clinical concern remains .
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In a retrospective analysis of 159 patients with LV thrombus, only 21.5% had a nonischemic cause.17 Mean LVEF was 32%, and the vast majority of LV thrombi occurred in the LV apex. Most patients were treated with OAC, with either a VKA or a DOAC, and 67% were also treated with an antiplatelet agent.
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