Utility of postural change in differentiating sludge from thrombus in the left atrial appendage: A case report |
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| Authors: | Hiroki Usuku MD PhD Eiichiro Yamamoto MD PhD Hiromi Yoshimura MD PhD Ryusuke Tsunoda MD PhD Kazuhiro Nishigami MD PhD Masamichi Nakajima MD PhD Ryusuke Suzuki MD PhD Kenichi Tsujita MD PhD |
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| Institution: | 1. Department of Cardiovascular Medicine, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan;2. Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan;3. Department of Cardiovascular Medicine, Miyuki Hospital, Kumamoto, Japan;4. Department of Cardiovascular Surgery, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan |
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| Abstract: | We detected symptomatic atrial fibrillation in a 64‐year‐old man who had undergone mitral valvuloplasty. While performing transesophageal echocardiography (TEE) in the left lateral decubitus position, we detected an isoechoic mass lesion at the bottom of the left atrial appendage (LAA). After changing the patient's position from left to right, the mass lesion dropped down from the bottom of the LAA, spread out into the left atrium, and appeared as a spontaneous echocardiographic contrast with mobility. We therefore diagnosed the mass lesion as not a thrombus but sludge. Changing the patient's position during TEE is useful for distinguishing sludge from thrombi. |
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| Keywords: | left atrial appendage thrombus left atrium transesophageal echocardiography |
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