Routine Screening with Contrast Echocardiography in Apical Infarctions? A case report

Area of Science:

• Cardiology
• Medical Imaging

Background:

• ST-elevation myocardial infarction (STEMI) patients are at risk for left ventricular (LV) thrombus formation.
• Transthoracic echocardiography is a common imaging modality for assessing cardiac structure and function post-MI.

Observation:

• Routine echocardiography with contrast initially excluded LV thrombus in a STEMI patient.
• A follow-up echocardiogram four months later revealed an apical LV thrombus, confirmed by contrast.
• A subsequent echocardiogram showed a new apical thrombus despite appearing normal without contrast.

Findings:

• Standard echocardiography can be inconclusive or falsely negative in detecting apical thrombus.
• Contrast echocardiography demonstrated thrombus in cases where standard imaging was unremarkable.

Implications:

• Contrast-enhanced echocardiography may be beneficial for routine screening in post-MI patients at high risk for apical thrombus.
• Improved detection of apical thrombus can potentially influence clinical management and outcomes.