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Updated: Oct 29, 2026

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Differentiating Coumadin Ridge From Thrombus in Dilated Left Atria: The Value of the Modified Apical 4-Chamber View
1Department of Cardiology, Bolu Abant Izzet Baysal University, Bolu, Turkey.
Abstract:
We read the study by Walczewski et al. The authors used the LATTEE registry to evaluate left atrial appendage (LAA) thrombus predictors. They call for comprehensive echocardiographic evaluation. We agree. Their analysis covers both sexes. Building on this, we highlight a shared diagnostic pitfall. The issue arises during the initial transthoracic echocardiography (TTE). Clinicians can misidentify the "Coumadin Ridge" (fold of Marshall) as a thrombus. This anatomical illusion affects men and women alike. It happens primarily in dilated left atria.
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