Spontaneous echocardiographic contrast (SEC) is an occasional finding observed in the atria in patients undergoing transesophageal echocardiographic studies, but has rarely been described in the descending thoracic aorta in the absence of an aortic dissection. The pathophysiology of SEC in the cardiac and vascular structures appears to be related to an interaction between red blood cells and plasma proteins in the setting of a low flow state. In this report we present three cases of SEC in the descending thoracic aorta, with one of the cases of SEC resolving with repair of his underlying cardiac disorder.

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