Spontaneous Echocontrast in Left Atrium

Spontaneous Echocontrast in Left Atrium


🔢 No.Spontaneous Echocontrast in Left Atrium🧠 Key Point
1SEC is an echogenic “smoke-like” swirling pattern seen in cardiac chambers.
2Most commonly observed in the left atrium and left atrial appendage (LAA).
3Caused by red blood cell aggregation (rouleaux formation) due to blood stasis.
4Strongly associated with atrial fibrillation and mitral stenosis.
5Presence of SEC indicates increased risk of left atrial thrombus formation.
6Transesophageal echocardiography (TEE) is more sensitive than TTE for SEC.
7SEC is a pre-thrombotic marker, not merely an incidental finding.
8Common in patients with LAA emptying velocity < 20 cm/s.
9SEC may precede or coexist with thrombus, especially in the LAA.
10Graded based on echogenicity and swirling density (mild, moderate, dense).
11Sluggish blood flow and dilated LA are predisposing factors.
12Associated with increased CHA₂DS₂-VASc scores in atrial fibrillation.
13SEC is an indication for anticoagulation in high-risk AF patients.
14Polycythemia and hypercoagulable states may increase SEC echogenicity.
15SEC can be mistaken for contrast microbubbles or artifacts if not assessed properly.
16TEE imaging of LAA in multiple planes is crucial to confirm SEC.
17Persistent SEC despite rhythm control implies ongoing stasis or dysfunction.
18SEC has been linked with increased risk of embolic stroke and TIA.
19LAA dysfunction can contribute to SEC even in sinus rhythm.
20Resolution of SEC after anticoagulation may indicate reduced thrombotic risk.

What is the finding in the Video?


[A] Dissection of Coronary Sinus

[B] Spontaneous Echocontrast in Left Atrium

[C] Ebstein anomaly

[D] Atrial Septal Defect



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