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Differentiating spontaneous echo contrast, sludge, and thrombus in the left atrial appendage: Can ultrasound enhancing agents help?
Author(s) -
PosadaMartinez Edith Liliana,
TrejoParedes Camila,
OrtizLeon Xochitl A.,
IveyMiranda Juan Betuel,
Lin Ben A.,
McNamara Robert L.,
AriasGodinez Jose Antonio,
Lombo Bernardo,
Sugeng Lissa
Publication year - 2019
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.14405
Subject(s) - thrombus , cardioversion , atrial fibrillation , medicine , cardiology , transesophageal echocardiogram , ultrasound , appendage , atrial appendage , radiology , anatomy , sinus rhythm
The accurate identification of thrombus in the left atrial appendage with transesophageal echocardiogram (TEE) in patients with atrial fibrillation (AF) before cardioversion is essential. Most of these patients have some grade of spontaneous echo contrast (SEC). Severe SEC is often called “sludge,” and its prognosis and treatment are still controversial. Current guidelines suggest the use of ultrasound enhancing agents (UEAs) when significant SEC is present. However, little is known about the utility of the UEAs in the differentiation between sludge and less severe SEC.