Thrombus and SOE ASYNC Flashcards
What is Cardiac Thrombus?
Coagulation of blood within the heart, appearing as echo dense mass with defined margins, commonly due to stasis or turbulent blood flow
What is the three points of Virchow’s Triad? (In terms of thrombus risk factors)
- Abnormal walls
- Abnormal blood flow
- Abnormal blood constituents
What causes the thrombus risk factor of abnormal walls? 7
Endothelial injuries such as
1. Atherosclerosis
2. MI
3. Trauma
4. Inflammation
5. Hypertension
6. Smoking
7. Increase in cholesterol
What causes thrombus risk factors of abnormal blood flow? 2
Hemodynamic changes such as
1. Stasis of blood
2. Turbulent flow
What causes thrombus risk factors of abnormal blood constituents? 4
Hypercoagulability from things like
1. Prolonged bed rest
2. MI
3. A fib
4. Prosthetic valves
What is spontaneous echo contrast also referred to as?
Smoke
What is spontaneous echo contrast a precursor to?
Thrombus
Spontaneous echo contrast can be sometimes be seen when?
With normal patients with good vis
What are three cardiac thrombus locations?
- LV thrombus
- LA thrombus (LAA thrombus)
- RT heart thrombus (RA, RV, PA)
What does this image represent?
Spontaneous echo contrast
What are some thrombus echo features?
- Echogenic mass
- Protruding vs Mural
- Mobile vs sessile
What can be said about the echogenic features of thrombus?
- Older thrombus becomes more echogenic
- Acute thrombus may be the same echogenicity of adjacent myocardium
What can be said about the protruding and mural features of thrombus echogenicity?
Protruding more acute and more at risk for embolus
What can be said about mobile echogenic thrombus?
More at risk for embolus
MIs commonly involve what part of the heart?
APEX
Most thrombi form near what?
APEX
Blood flow velocity is lowest near what?
Apex
What kind of blood will clot?
Stagnant blood
Thrombus formation with MI location is where? 2
- Anterior LAD (30%)
- Inferior RCA (5%)
When does thrombus normally happen?
2 weeks post MI
In terms of embolization of thrombi, when will it normally happen?
1-3 months post MI
What is the frequency of embolization of thrombi?
10%
What increases the risk for embolization?4
- Protruding
- Large size
- Mobile
- Adjacent to hypermobile segment
What does LV thrombus requires for viewing?
- 2 views for visualization
- High frequency probe and zoom