[Spontaneous echo contrast in transesophageal echocardiographic examination: clinical ultrasonic analysis].

The clinical and echocardiographic variables related to spontaneous echo contrast were evaluated in a consecutive series of 600 patients undergoing transesophageal echocardiography with a 5-MHz single plane transducer. The spontaneous contrast was observed in 110 patients (18%). It was seen mainly in the atria; in the left atrium in 98, in the right atrium in 2 patients, in both atria 7, in the vena cava superior and right atrium in 1, in the left atrium and ventricle in 1, and in the false lumen of dissected aorta. Spontaneous atrial contrast was never seen in the absence of cardiac abnormality. There was a high incidence of atrial spontaneous echo contrast in cases of significant mitral stenosis, mitral valve prosthesis, atrial fibrillation, enlarged left atrium and absence of significant mitral regurgitation which were showed by univariate analysis. Multivariate analysis showed that atrial fibrillation, significant mitral stenosis and enlarged left atrium were independent factors for the presence of spontaneous contrast. Thus, spontaneous echocardiographic contrast detected by transesophageal echocardiography is a common finding in patients with mitral stenosis, atrial fibrillation and enlarged left atrium, in the absence of significant mitral regurgitation.