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Utility of postural change in differentiating sludge from thrombus in the left atrial appendage: A case report
Author(s) -
Usuku Hiroki,
Yamamoto Eiichiro,
Yoshimura Hiromi,
Tsunoda Ryusuke,
Nishigami Kazuhiro,
Nakajima Masamichi,
Suzuki Ryusuke,
Tsujita Kenichi
Publication year - 2018
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13850
Subject(s) - appendage , thrombus , cardiology , medicine , atrial appendage , atrial fibrillation , anatomy , sinus rhythm
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.