A 55-year-old man with a large anterior STEMI develops an apical left ventricular thrombus 5 days post-infarction. He has no evidence of bleeding. According to current guidelines, what is the recommended duration of anticoagulation for this finding?

• A 1 week
• B 1 month
• C Lifelong
• D 3 to 6 months ✓

Explanation

Current ACC/AHA guidelines recommend anticoagulation for LV thrombus detected after MI, typically with warfarin or a DOAC, for at least 3 to 6 months, with repeat imaging to confirm resolution. Lifelong anticoagulation is reserved for recurrent thrombus or persistent LV dysfunction with ongoing risk, but the standard initial course is 3 to 6 months.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

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