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Unusual findings of M-mode echocardiogram in a case with left ventricular thrombus
Insights
Unusual M-mode echocardiogram findings revealed a band-like echo in the left ventricle. This "band like" echo, typically seen in myxoma, was identified as a left ventricular thrombus in a patient with myocardial infarction.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Acute myocardial infarction can lead to left ventricular thrombus formation.
- M-mode echocardiography is a crucial tool for cardiac assessment.
Observation:
- A 41-year-old male presented with hypokinesis of the inferior and inferolateral walls post-myocardial infarction.
- M-mode echocardiogram demonstrated dense, thick, linear, "band like" echoes near the apex, denser than the myocardium.
Findings:
- These abnormal "band like" echoes were confirmed by 2D echocardiogram, CT, and left ventriculogram.
- The echoes were attributed to an index finger-sized left ventricular thrombus.
- The characteristic "band like" echo pattern, usually associated with left ventricular myxoma, was observed.
Implications:
- This case highlights that "band like" echoes on M-mode echocardiography can represent left ventricular thrombus.
- Such findings are critical in diagnosing thrombus in conditions like myocardial infarction, ventricular aneurysm, dilated cardiomyopathy, and heart failure.
Abstract:
The unusual echo findings of the left ventricular thrombus by M-mode echocardiogram is reported. The patient was a 41-year-old man with hypokinesis of the inferior and inferolateral wall due to acute myocardial infarction. The findings of M-mode echocardiogram revealed dense thick linear echoes just below the anterior wall of the apex, which had a higher density than the myocardium and looked "band like". These abnormal echoes obtained by M-mode echocardiogram were also detected through examinations by 2-dimensional echocardiogram, computed tomogram and left ventriculogram, and were assumed to arise from the index finger-sized thrombus in the left ventricle at the time of surgical procedure. Although this abnormal echo, revealed to have a "band like" feature by M-mode echocardiogram, is usually seen in the left ventricular myxoma, we assume that this "band like" echo by M-mode echocardiogram arose from the left ventricular thrombus under conditions such as myocardial infarction, ventricular aneurysm, dilated cardiomyopathy and long-term congestive heart failure.