ABSTRACT
Thrombosis of a mechanical heart valve (Figure 10.1A,B) is an infrequent, yet potentially life-threatening complication, requiring immediate diagnosis and treatment. It occurs more frequently in patients who are non-compliant with anticoagulation therapy, but may occur in the presence of adequate anticoagulation. The clinical presentation may vary from insidious dyspnoea, to pulmonary oedema and cardiogenic shock. Cerebral or peripheral emboli, or acute myocardial infarction due to a coronary emboli (Figure 10.2A,B) may be the initial signs of valve thrombosis,1-5 but the most frequent clinical finding is congestive heart failure, in about half of the patients.6
