Case Blog - (2021) Volume 9, Issue 6
Received: 21-Jun-2021
Published:
30-Jun-2021
, DOI: 10.37421/2329-9517.2021.9.455
Citation: Mohammad Kasaei. “Thrombus in Left Atrial Appendage (LAA)”. J Cardiovasc Dis Diagn 9 (2021) 9:455.
Copyright: © 2021 Kasaei M. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
A thrombus is identified in the left atrium during CMR examination of a 70 years old lady with atrial fibrillation and LV dysfunction. The left atrium was severely enlarged (289 ml, 170 ml/m2) with a lobulated filling defect found in the left atrial appendage in the first pass perfusion image of the heart. Patients with significant enlargement of the left atrium especially when having atrial fibrillation and poor LA contractility are typical cases for the clot in the left atrium and dynamic perfusion images followed by the early post contrast images should be applied using 2 chamber multi slices to have the full coverage of the left atrium and left atrial appendage in this standard cardiac image plane. Evaluating delayed enhancement images revealed discrete area of sub-endocardial (ischemic scar in the lateral wall of the left ventricle together with extensive fibrosis of the left atrium extending to the AV node area (Figures 1-3).
Figure 1. Thrombus with atrial fibrillation and left ventricular dysfunction identified in the left atrium in the cardiovascular magnetic resonance image.
Figure 2. Severely enlarged Left atrium with a lobulated filling defect in the left atrial appendages.
Figure 3. Sub-endocardial ischemic scar in the lateral wall of the left ventricle.
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