Why the study?
Does contrast echocardiography provide incremental value in the evaluation of a cardiac thrombus compared to standard echocardiography?
Does contrast echocardiography provide incremental value in the evaluation of a cardiac thrombus compared to standard echocardiography?
Contrast echocardiography can provide critical incremental value in assessing the attachment and embolic risk of cardiac masses, even when the diagnosis of a thrombus is already certain.
May aid thrombus characterization in select cases; hypothesis-generating and should not yet change practice.
A 52-year-old man presented with altered mental status and report of prior complaint of chest pain. On electrocardiography, anterolateral ST-segment elevations with Q-waves in the septal leads were seen. Initial echocardiography images demonstrated a thickened anteroseptum. Further imaging showed the presence of a well-attached laminated apical thrombus. Contrast echocardiography images showed that the thrombus had minimal attachment to the endocardial surface. CT head subsequently showed the presence of acute stroke. The case demonstrates the additional value of contrast echocardiography in the evaluation of cardiac masses despite the certainty in the diagnosis of a thrombus.
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Po et al. (2017) studied this question.
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