A patient with paroxsysmal atrial fibrillation is planed for rhythm controll therapy and cardioversion. The black and white videos show the non contrast enhanced pictures with an echogenic structure in the apex of the left atrial appendage. Is this a trabecula or an echogenic thrombus? The video was demonstrated on the german echocardiography congress in…

Sorry, this entry is only available in german. Kodierung von Kontrastmitteluntersuchungen, Stand 2011:

This example shows a mobile structure at the entrance of the left atrial appendage. With tissue velocity imaging, there is an alaising in the area of the highly mobile thrombus. After the injection of a contrast agent, the mobile thrombus is not visible. Therefore, a broad-based filling defect can be recognized, a “laminated” thrombus. Unfortunately,…

After injection of contrast medium the signal difference between the chamber and the myocardium is at its greatest during the early wash in phase of the left ventricle. The capillaries of the ventricular myocardium are not yet filled with contrast bubbles and so not yet stained, while the chamber is already completely stained. The kinetics…

The following video shows a mobile thrombus in the left atrial appendage:      

Large spout thrombus in the left atrial appendage. Small laminated thrombus in the region of the lateral mitral annulus, seen as a narrow black contrast free line.    

Intense spontaneous echo contrast makes it difficult to delineate the thrombus in the left atrial appendage. After contrast agent administration, it is easy to identify the thrombus.

This video shows a questionable floating structure at the lateral wall of the left atrial appendage. This video was shown at the German echocardiography congress in Cologne (EKK) in 2011 as part of a contrast workshop. The participants rated this video as follows: a normal left atrial appendage, cardioversion allowed: 2 % a dilated left…