Spontaneous Echo Contrast Mistaken for Left Ventricular Thrombus during Venoarterial Extracorporeal Membrane Oxygenation

Spontaneous echo contrast (SEC) is often observed in patients with mitral stenosis, atrial fibrillation, cardiomyopathy, or a ventricular aneurysm SEC is a smoke-like echo density observed on echocardiograms, and is caused by increased red blood cell aggregation during low-flow states. It is also a risk factor of thromboembolism SEC can be observed in patients with severe ventricular dysfunction receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO).