Left ventricular thrombi in children with dilated cardiomyopathy.

To define the nature and course of left ventricular (LV) thrombi in pediatric patients, the charts and echocardiographic records of 32 pediatric patients with dilated cardiomyopathy from 1986 to 1991 were retrospectively reviewed. Five patients who were identified according to echocardiographic evidence of LV thrombi fulfilled the criteria of dilated cardiomyopathy. Systemic embolization occurred in three patients with LV thrombi who invariably died despite anticoagulant treatment. Although it was not statistically significant, patients with LV thrombi tended to have a lower ejection fraction compared to patients without LV thrombi. The morphology of LV thrombi in patients with systemic embolization showed nonprotruding features. Thus, children with dilated cardiomyopathy are at risk of developing LV thrombi and systemic embolization. Although it was not possible to identify the risk factors, the risk of developing LV thrombi and systemic embolization may be higher in patients with lower ejection fraction of the left ventricle.