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Incidence and factors influencing left atrial clot in patients with mitral stenosis and normal sinus rhythm
  1. S J Saidi1,
  2. M H K Motamedi2
  1. 1Department of Cardiology, Baqiatallah University of Medical Sciences, Tehran, Iran
  2. 2Department of Cardiovascular Surgery, Baqiatallah University of Medical Sciences, Tehran, Iran
  1. Correspondence to:
    Dr S Jalal Saidi
    254, Entrance 8, Block-E1, Phase 3, Shahrak Ekbatan, Tehran, Iran; saidi39yahoo.com

https://doi.org/10.1136/hrt.2003.024315

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    Mitral stenosis (MS) is a common finding in rheumatic heart disease and can lead to enlargement of the left atrium and stasis of blood in this heart chamber. This can lead to an increased risk of clot formation in the left atrium and the left atrial appendage.

    In numerous studies to date, various precipitating factors for the formation of a clot inside the left atrium have been identified, including atrial fibrillation (AF) rhythm, left atrial size, duration of symptoms, advanced age, and severity of MS. Furthermore, mitral regurgitation (MR) in conjunction with MS has been mentioned as a factor which reduces the risk of left atrial clot formation.1–3

    This study was performed to determine the incidence of left atrial clot in a group of patients who remained in normal sinus rhythm (NSR) and to establish the factors which play a determining role in this process.

    METHODS

    In this descriptive, analytical study, 203 patients with MS, who presented to our department for percutaneous mitral valvuloplasty or mitral valve surgery from January 2001 to February 2002, were studied. All patients underwent transthoracic and transoesophageal echocardiography and the results were recorded and analysed.

    RESULTS

    Forty three patients (21.3%) were male. Median age was 44.8 (12.3) years. Of the patients studied, 88 patients (43.4%) had pure MS, 47 patients (23.2%) had MS plus MR, and 68 patients (33.5%) …

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