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Spontaneous echocardiographic contrast in the descending aorta
R Castello1, A C Pearson, L Fagan
1Division of Cardiology, St. Louis University School of Medicine, MO.
Insights
Echocardiographic spontaneous contrast, typically linked to cardiac issues, was observed in the descending aorta in four patients. This finding occurred even in a patient with a normal heart, suggesting broader implications.
Area of Science:
- Cardiovascular Imaging
- Echocardiography
- Hemodynamics
Background:
- Spontaneous echocardiographic contrast is a known phenomenon, often associated with low flow states within cardiac chambers.
- Its pathophysiology remains incompletely understood.
- Traditionally considered an indicator of cardiac abnormalities or symptoms.
Abstract:
The visualization of echocardiographic spontaneous contrast is a common phenomenon in patients undergoing transesophageal echocardiographic studies. Its pathophysiology is not well understood, but it has been related to the presence of a low flow state in the cardiac chambers. We report the presence of spontaneous contrast in the descending aorta of four patients, a location not previously described in the absence of aortic dissection. In two patients, spontaneous contrast was noted in both the left atrium and the descending aorta. In one patient with moderate left ventricular dysfunction, spontaneous contrast was noted in the descending aorta and in the left ventricle. In the remaining case, no cardiac or aortic abnormalities were observed and this represents the first time that spontaneous contrast has been identified in a patient with an echocardiographically normal heart. The occurrence of spontaneous contrast has been considered an abnormal echocardiographic finding, since it has always been described in patients with clinical symptoms and cardiac abnormalities. The fact that spontaneous contrast can be visualized in patients with very mild structural cardiac abnormalities or none at all, warrants further investigation, especially when therapeutic or prognostic implications are considered.