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Thrombus or Papillary muscle??
This transthoracic apical clip shows a mobile density in the LV cavity. It is challenging to say based on this single clip whether this is a thrombus or a segment of the papillary muscle. The patient has been on therapeutic doses of warfarin for the mechanical mitral valve that can be seen. Also, other clips from this study more reliably demonstrate that this is likely a segment of the papillary muscle.
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This transthoracic apical clip shows a mobile density in the LV cavity. It is challenging to say based on this single clip whether this is a thrombus or a segment of the papillary muscle. The patient has been on therapeutic doses of warfarin for the mechanical mitral valve that can be seen. Also, other clips from this study more reliably demonstrate that this is likely a segment of the papillary muscle.
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St. Jude mechanical mitral valve causing spontaneous cavitation in the LV
This transthoracic apical clip shows bubbles being spontaneously formed (cavitation) by this patient\s mechanical St. Jude mitral valve.
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This transthoracic apical clip shows bubbles being spontaneously formed (cavitation) by this patient\s mechanical St. Jude mitral valve.
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Severe RV pressure overload with septal flattening
This transthoracic clip shows the RV and LV in parasternal short axis. The RV pressure (estimated by TR doppler at 60-70 mmHg) is causing RV dysfunction and septal flattening.
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This transthoracic clip shows the RV and LV in parasternal short axis. The RV pressure (estimated by TR doppler at 60-70 mmHg) is causing RV dysfunction and septal flattening.
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Classic appearance of RV failure in acute pulmonary embolus 2 of 2
This transthoracic echo clip shows the right ventricle in response to acute PE with RV stretch and dysfunction, however the apex continues to contract. The radiology report from the patient\s CTPA reads: CT evaluation of the chest demonstrates a ginormous saddle embolus involving both main pulmonary arteries with smaller areas of thrombus extending into all lobes./nThe patient is 37 years old and has a glioblastoma.
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This transthoracic echo clip shows the right ventricle in response to acute PE with RV stretch and dysfunction, however the apex continues to contract. The radiology report from the patient\s CTPA reads: CT evaluation of the chest demonstrates a ginormous saddle embolus involving both main pulmonary arteries with smaller areas of thrombus extending into all lobes./nThe patient is 37 years old and has a glioblastoma.
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Classic appearance of RV failure in acute pulmonary embolus 1 of 2
This transthoracic echo clip shows the right ventricle in response to acute PE with RV stretch and dysfunction, however the apex continues to contract. The radiology report from the patient\s CTPA reads: CT evaluation of the chest demonstrates a ginormous saddle embolus involving both main pulmonary arteries with smaller areas of thrombus extending into all lobes./nThe patient is 37 years old and has a glioblastoma.
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This transthoracic echo clip shows the right ventricle in response to acute PE with RV stretch and dysfunction, however the apex continues to contract. The radiology report from the patient\s CTPA reads: CT evaluation of the chest demonstrates a ginormous saddle embolus involving both main pulmonary arteries with smaller areas of thrombus extending into all lobes./nThe patient is 37 years old and has a glioblastoma.
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What on earth is this LV apical mass? 2 of 2
A man in his 40\s presents with an new onset heart failure, severe HTN (SBP ~240) and this mass in his LV. What could it be? Is it thrombus?
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A man in his 40\s presents with an new onset heart failure, severe HTN (SBP ~240) and this mass in his LV. What could it be? Is it thrombus?
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What on earth is this LV apical mass? 1 of 2
A man in his 40\s presents with an new onset heart failure, severe HTN (SBP ~240) and this mass in his LV. What could it be? Is it thrombus?
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A man in his 40\s presents with an new onset heart failure, severe HTN (SBP ~240) and this mass in his LV. What could it be? Is it thrombus?
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Apical Ballooning Syndrome in a 90yo woman 1 of 2
TTE clip of a woman who was admitted with acute CHF having a normal echo about two weeks prior and a history of hypertensive emergency. On arrival this time, her BP was 90 systolic. By the next day she was extubated and feeling much better. Troponin was 0.06 and ECG was paced, but unchanged.
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TTE clip of a woman who was admitted with acute CHF having a normal echo about two weeks prior and a history of hypertensive emergency. On arrival this time, her BP was 90 systolic. By the next day she was extubated and feeling much better. Troponin was 0.06 and ECG was paced, but unchanged.
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Toshiba Artida 2D LV Wall Tracking
http://www.medical.toshiba.com/Products/US/Artida/
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http://www.medical.toshiba.com/Products/US/Artida/
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Severe Aortic valve stenosis and calcification
This parasternal short axis TTE clip of the aortic valve demonstrates that shi valve is severely calcified and appears very stenotic. Doppler estimated pressure gradient across this valve was between 60 and 80 mm Hg at peak.
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This parasternal short axis TTE clip of the aortic valve demonstrates that shi valve is severely calcified and appears very stenotic. Doppler estimated pressure gradient across this valve was between 60 and 80 mm Hg at peak.
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Bioprosthetic Aortic Valve
This transthoracic TTE clip shows a patient with a bioprosthetic aortic valve. The doppler study was limited but it did not appear to have any significnat stenosis or regurgitation.
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This transthoracic TTE clip shows a patient with a bioprosthetic aortic valve. The doppler study was limited but it did not appear to have any significnat stenosis or regurgitation.
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Positive Bubble Study with interatrial shunting
This four chamber apical TTE clip shows \bubbles\ or agitated saline being administered through a peripheral vein with the patient performing a valsalva maneuver. The result is immediate appearance of bubbles in the left circulation consistent with interatrial shunting. The quality is not great, but you can see the single bubbles floating in the LV within 1-2 beats of the heart after injection of the saline.
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This four chamber apical TTE clip shows \bubbles\ or agitated saline being administered through a peripheral vein with the patient performing a valsalva maneuver. The result is immediate appearance of bubbles in the left circulation consistent with interatrial shunting. The quality is not great, but you can see the single bubbles floating in the LV within 1-2 beats of the heart after injection of the saline.
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Inferior wall akinesis results in moderate left ventricular dysfunction
This parasternal long axis TTE clip shows that this patient has moderate LV dysfunction that is a result of inferior wall akinesis while the septum thickens normally. The rest of the study showed isolated akinesis of inferior segments of the heart.
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This parasternal long axis TTE clip shows that this patient has moderate LV dysfunction that is a result of inferior wall akinesis while the septum thickens normally. The rest of the study showed isolated akinesis of inferior segments of the heart.
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Severe LV Dysfunction
This parasternal long axis TTE clip shows severe dysfunction of the left ventricle. Note the poor endocardial contraction as well as the poor excursion of the anterior leaflet of the mitral valve.
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This parasternal long axis TTE clip shows severe dysfunction of the left ventricle. Note the poor endocardial contraction as well as the poor excursion of the anterior leaflet of the mitral valve.
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Moderate Mitral Regurgitation
This parasternal long axis TTE clip shows moderate mitral regurgitation. Note that the jet is directed posteriorly and somewhat laterally.
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This parasternal long axis TTE clip shows moderate mitral regurgitation. Note that the jet is directed posteriorly and somewhat laterally.
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Moderate Aortic Calcification
This parasternal long axis TTE clip shows the aortic valve with moderate calcification and thickening. The pressure gradient across this valve was estimated to be 25 at peak.
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This parasternal long axis TTE clip shows the aortic valve with moderate calcification and thickening. The pressure gradient across this valve was estimated to be 25 at peak.
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Aortic Sclerosis
This parasternal long axis TTE clip shows an aortic valve that is, sclerotic with mild calcification and mild thickening. This is a common finding in the elderly. There was not a significant pressure gradient measured on doppler.
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This parasternal long axis TTE clip shows an aortic valve that is, sclerotic with mild calcification and mild thickening. This is a common finding in the elderly. There was not a significant pressure gradient measured on doppler.
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TEE biplane of the aortic valve
This TEE clip shows the aortic valve using a biplanar probe with the short axis on the left and the outflow track on the right.
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This TEE clip shows the aortic valve using a biplanar probe with the short axis on the left and the outflow track on the right.
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Is this the coronary sinus?
This clip shows a transthoracic view of what appears in the area where you might expect to find the coronary sinus (arrow), but it is quite large. This patient also was recently diagnosed with a lung cancer, and other imaging modalities seem to indicate the possibility of metastasis to the pericardial area and specifically to the inferior aspects. Could this be a metastatic complication of some sort?
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This clip shows a transthoracic view of what appears in the area where you might expect to find the coronary sinus (arrow), but it is quite large. This patient also was recently diagnosed with a lung cancer, and other imaging modalities seem to indicate the possibility of metastasis to the pericardial area and specifically to the inferior aspects. Could this be a metastatic complication of some sort?
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