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The Role of Echocardiography in the Evaluation of Cardiac Source of Embolism:
Author(s) -
BLACK IAN W.,
STEWART WILLIAM J.
Publication year - 1993
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/j.1540-8175.1993.tb00054.x
Subject(s) - medicine , cardiology , atrial fibrillation , stenosis , mitral regurgitation , embolism , hematocrit , blood viscosity , mitral valve stenosis , fibrinogen , radiology
Left atrial (LA) spontaneous echo contrast, also known as “smoke”, is a frequent transesophageal echocardiographic finding characterized by swirling, smokelike echoes in the LA cavity or appendage. LA smoke is associated with conditions favoring stasis of LA blood, including atrial fibrillation, mitral stenosis, the absence of mitral regurgitation, and LA enlargement. LA spontaneous echo contrast is a marker of previous embolic events in patients with atrial fibrillation, mitral stenosis, or mitral valve replacement. Most LA thrombi are accompanied by smoke. Recent studies show that LA spontaneous echo contrast is also associated with increased fibrinogen, hematocrit, and blood viscosity, indicating a relatively hypercoagulable state in addition to stasis. These findings suggest that LA spontaneous echo contrast is a manifestation of erythrocyte aggregation, and that hematologic factors may contribute to the association between spontaneous echo contrast and thromboembolism.