Ventricular mural thrombi - An occult occurrence?

Background: Ventricular mural thrombi are rare occurrences and form one of the common mechanical complications of myocardial infarctions. They also occur in patients with nonischemic myocardial disorders and even in those devoid of cardiac diseases. Clinical detection often depends on the size of the thrombi. Aim: This study was aimed at ascertaining the etiopathogenesis of mural thrombi with a clinicopathologic correlation. Materials and Methods: This was a 12-year retrospective observational study reviewing the autopsy records of all cases showing ventricular mural thrombi. The location, size, morphology, and histologic appearances of the thrombi were noted. The cases, depending on the etiology, were categorized into myocardial ischemic (Group 1), myocardial nonischemic (Group 2), and non-myocardial (Group 3) causes. These features were correlated with the clinical settings. Results: There were 93 cases of mural thrombi with an almost equal sex distribution and a mean age of 45.9 years. The cause was ischemic heart disease in most of the patients (Group 1, 46.2%), while 21.5% and 32.3% of patients belonged to Group 2 and Group 3, respectively. Unlike the large and dominantly left ventricular thrombi seen in Group 1, the other two groups frequently had biventricular involvement, location in the intertrabecular spaces, and a high microscopic detection. Clinical diagnosis had been made in only 3.2% of patients. Thromboembolism was noted in other organs in 34.4% of the total cases. Conclusion: Ventricular thrombi should be ruled out in patients with evidence of systemic and/or pulmonary thromboembolism, even in those without any cardiac disorders.

Leadership effort in professional radiology associations.

Professional associations advocate for their members' interests; provide forums for education, training, and certification; and support domain-specific research and development efforts. The purpose of this study was to determine the amount of resources devoted to the leadership committees of professional radiology associations in the United States. Internet research was conducted to identify general, subspecialty, and special interest radiology associations, followed by a survey that focused on the number of committees and the average number of members per committee for each association. Established or published benchmarks were used to calculate committee-related annual expenditures from the survey data. Two hundred forty full-time equivalents, or nearly $100 million, are devoted to leadership activities within radiology associations each year. This is equivalent to approximately 1% of the professional income in radiology. These resources have enabled individual radiologists and societies to cooperate on important initiatives. More research should be conducted on other specialties or industries to provide comparable data on the optimal investment in the leadership effort.