A Tricky Left Atrial Clot : Easy to Miss ! скачать в хорошем качестве

A Tricky Left Atrial Clot : Easy to Miss !

An elderly gentleman in the ICU was being ventilated after an embolic stroke involving the left MCA territory. I was requested by the intensivist to have a look at the heart to rule out a cardiac source of embolus. The patient had significant LV systolic and diastolic dysfunction. A comprehensive TEE examination was performed. At first appearance no clear source of thrombus was obvious. Something suspicious was found at the LV apex which was akinetic but could not be stamped a LV clot. The LA appendage did not show any clot at the initial echocardiographic scan. However on a re-look - especially after reducing depth, narrowing the sector angle and using the zoom function the LA appendage clot became obvious.