Lysis of a left ventricular thrombus with recombinant tissue plasminogen activator

Chest. 2001 Aug;120(2):681-3. doi: 10.1378/chest.120.2.681.


A 23-year-old woman with peripartum cardiomyopathy presented with a 2.1 x 2.5-cm pedunculated, mobile, left ventricular thrombus and evidence of systemic embolization. Due to the patient's poor left ventricular function, thrombectomy was not a viable option. Treatment with high-dose IV heparin was initially utilized but was unsuccessful as the thrombus appeared to enlarge on echocardiography. An accelerated weight-adjusted dose of recombinant tissue plasminogen activator (rt-PA) successfully lysed the thrombus without evidence of embolization. Although rt-PA has been used for primary lysis of high-risk ventricular thrombi, this is the first documentation of successful lysis of a left ventricular thrombus in a patient with peripartum cardiomyopathy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cardiomyopathies / complications
  • Female
  • Heart Diseases / therapy*
  • Humans
  • Puerperal Disorders / therapy
  • Recombinant Proteins / therapeutic use
  • Thrombosis / therapy*
  • Tissue Plasminogen Activator / therapeutic use*


  • Recombinant Proteins
  • Tissue Plasminogen Activator