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Transesophageal Echocardiographic Evidence for Acute Right Atrial Dysfunction
Jesús Vargas-Barrón1, Angel Romero-Cárdenas, Nilda Espínola-Zavaleta
1Department of Echocardiography, Instituto Nacional de Cardiología "Ignacio Chávez," Juan Badiano No. 1, 14080 México, D.F., Mexico.
Abstract:
We describe the clinical course and echocardiographic findings of a 64-year-old man who was hospitalized with an infarction of the inferior myocardial wall of 5 days' evolution and extension to the right ventricle. Transesophageal echocardiography showed biventricular inferior dyssynergia and akinesis of the right atrial wall. One thrombus was visible in the right atrial appendage, and another crossed the foramen ovale and reached the mitral valve. After the patient received anticoagulant agents, transesophageal studies showed the disappearance of atrial thrombi, as well as recuperation of right atrial movement and active participation of atrial contraction in right ventricular filling. The findings of these serial echocardiograms support the existence of ischemic right atrial stunning manifested by wall akinesis that favored slow atrial flow and the formation of thrombi.