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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques

Published on: June 11, 2019

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Incremental value of contrast echocardiography in the evaluation of a cardiac thrombus

Jose Ricardo F Po1, Matthew S Tong1, Erica L Grove1

  • 1Allegheny General Hospital, Pittsburgh, PA, USA.

Echocardiography (Mount Kisco, N.Y.)
|January 6, 2017
PubMed

Insights

This case highlights how contrast echocardiography aids in diagnosing cardiac thrombi, even when a stroke is present. It reveals subtle thrombus details, improving cardiac mass evaluation.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Neurology

Background:

  • A 52-year-old male presented with altered mental status and a history of chest pain.
  • Electrocardiography revealed anterolateral ST-segment elevations and septal Q-waves, suggestive of myocardial infarction.
  • Initial echocardiography showed a thickened anteroseptum.

Observation:

  • Further imaging identified a laminated apical thrombus with minimal endocardial attachment.
  • Contrast echocardiography provided enhanced visualization of the cardiac mass.
  • A computed tomography (CT) scan of the head confirmed an acute stroke.

Findings:

  • The case illustrates a patient with findings consistent with myocardial infarction, cardiac thrombus, and subsequent stroke.
  • Contrast echocardiography proved valuable in characterizing the cardiac thrombus, detailing its attachment and morphology.
  • The diagnostic pathway involved electrocardiography, echocardiography, contrast echocardiography, and CT head.

Implications:

  • Contrast echocardiography offers incremental value in assessing cardiac masses, particularly in differentiating thrombi from other cardiac tumors.
  • Early and accurate characterization of cardiac thrombi is crucial for preventing embolic events, such as stroke.
  • This case underscores the importance of comprehensive cardiac imaging in patients presenting with neurological deficits and cardiac symptoms.

Keywords:
contrast echocardiographyleft ventricular massstrokethrombus

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