[Role of transesophageal echocardiography in the evaluation of the potential embolic risk in left atrial thrombosis. Report of a clinical case].
We describe the case of a 73-year-old man with cardiac failure due to hypertensive heart disease, chronic atrial fibrillation, prior ischemic stroke and acute ischemia of the left leg probably embolic in nature, in whom transthoracic echocardiography (TTE) detected a large left atrial mass compatible with thrombus. Transesophageal echocardiography (TEE) was performed to better evaluate the atrial mass. TTE showed a mass that was firmly attached to the wall of the left atrium, compact, homogeneous and stationary, indicating a relatively low embolic risk. On the other hand TEE clearly detected a marked motility and echographic unhomogeneity of the atrial mass, suggesting a poorer prognosis and urgent surgical referral due to high impending embolik risk. This case further supports the superiority of TEE to TTE in the assessment of intracardiac masses and, in particular, of embolik risk in a patient with left atrial thrombosis.
Iannoni
E
E
INRCA sede di Ancona, Ospedale Geriatrico Servizio di Cardiologia.
Mocchegiani
R
R
Peruzzini
M
M
Gigli
L
L
Bassotti
S
S
Vittori
N
N
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy; D016279:Atrial Function, Left; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal; D004617:Embolism / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005500:Follow-Up Studies; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D012307:Risk Factors; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000188:drug therapy; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D014859:Warfarin
Ruolo dell'ecocardiografia transesofagea nella valutazione del potenziale rischio embolico della trombosi atriale sinistra. Descrizione di un caso clinico.