31. Which of the following statements is true regarding stroke and myocardial infarction?

A. Warfarin is not recommended for 3 months after all anterior myocardial infarctions

B. Warfarin is recommended for 3 months after a myocardial infarction that results in an akinetic segment

C. Warfarin is recommended for 3 months after a myocardial infarction when there is an akinetic segment and a cardiac source of embolus

D. Warfarin is not recommended after myocardial infarction

E. Both B and C are correct

 

After myocardial infarctions (especially anteriorly), the myocardial stunning that occurs can result in blood pooling toward the akinetic segment (frequently the cardiac apex) resulting in thrombus formation. Embolization of this thrombus can cause a stroke. There is no good data in regards to prevention of left ventricular thrombi, however the ACC/AHA guidelines give a class I, level of evidence B recommendation to warfarin therapy for 3 months when there is a cardiac source of embolus suspected after a myocardial infarction.