[Spontaneous echo contrast in atrium with rheumatic heart disease by transesophageal echocardiography and its potential relation to thrombus].

The prevalence of atrial spontaneous echo contrast (SEC) and mural thrombus were evaluated in 154 consecutive patients undergoing transesophageal echocardiography (TEE) and transthoracic echocardiography (TTE). By TEE, SEC was observed in 106 patients (68.8%). Of them, 103 were seen in left atrium and only 3 were seen in right atrium. No SEC and mural thrombus were seen by TTE. Patients with mitral stenosis were in 82 of 154 patients, SEC was seen in 74 of those 82 patients (90%). Mechanical stenosis in mitral orifice is a predominant factor. Our analysis showed significant relation between the presence of SEC and atrial fibrillation (P < 0.005); left atrial enlargement (P < 0.001) and cardiac days function (P < 0.005). Of the 106 patients with SEC, 41 (38.7%) were in sinus rhythm and only 8 with the left atrial diameter > 60 mm. Left atrial mural thrombus was noted in 52/154 (33.6%), 42 of those 52 were patients with SEC (80%), which also suggest a significant relation between the presence of SEC and mural thrombus (P < 0.025). Thus SEC is a common phenomenon in patients with rheumatic heart disease. Its relation to thrombus formation and prognostic significance requires further evaluation.