Prevalence and Risk Factors of Left Atrial Thrombus in Mitral Stenosis: A Cross-Sectional Study

Background

Mitral stenosis, primarily caused by rheumatic heart disease, is a progressive valvular disorder with a significant risk of left atrial (LA) thrombus formation. Identifying the prevalence and associated risk factors of LA thrombus is crucial for improving clinical management and preventing thromboembolic complications. This study aimed to determine the prevalence of LA thrombus in patients with mitral stenosis and to identify associated risk factors, including hypertension, diabetes, atrial fibrillation, and smoking.

Methodology

A cross-sectional study was conducted at the Department of Cardiology, Mardan Medical Complex, KP Pakistan from April to October 2024. A total of 100 patients diagnosed with mitral stenosis were enrolled. Demographic, clinical, and echocardiographic data were collected, and transesophageal echocardiography (TEE) was performed to detect LA thrombus. Statistical analyses were conducted to determine associations between thrombus formation and potential risk factors, including hypertension, diabetes, atrial fibrillation, and smoking.

Results

The mean age of the participants was 43.7 ± 13.4 years, with a nearly equal gender distribution (49.0% males, 51.0% females). LA thrombus was detected in a significant proportion of patients. Hypertension, diabetes, atrial fibrillation, and smoking were found to be strongly associated with thrombus formation (p < 0.05). Patients with severe mitral stenosis had a higher prevalence of LA thrombus compared to those with moderate stenosis.

Conclusion

LA thrombus is a notable complication in mitral stenosis, particularly in patients with metabolic and cardiovascular comorbidities. Routine TEE screening and aggressive management of risk factors, including hypertension and diabetes, are essential for reducing thromboembolic events in these patients.