Detection of Left Atrial Appendage Thrombus by Spiral CT Scan

Alam, Golam; Addo, Frank; Malik, Mahr; Levinsky, Richard; Lieb, David C.

doi:10.1046/j.1540-8175.2003.00016.x

Cited by 10 publications

(1 citation statement)

References 4 publications

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“…Subsequent thrombophilia testing and stool cultures were normal. The leg embolus may have arisen from either the left ventricular or atrial appendage clot.Computerized tomography may successfully demonstrate left atrial appendage clot non-invasively and rapidly [1,2]. The left atrial appendage is the most common source of embolic clot, particularly in atrial fibrillation.…”

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Left atrial appendage thrombus revealed by 16-slice cardiac computerized tomography

Foley¹,

Peebles²,

Morgan³

2006

Journal of Cardiovascular Medicine

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A 46-year-old man presented with a painful calf after becoming unwell with a diarrhoeal illness for the previous week. He was jaundiced with signs of right heart failure, and had a pulseless right foot. An electrocardiogram confirmed atrial fibrillation. The right heart was dilated on echocardiography, with evidence of pulmonary hypertension. There was global poor left ventricular function, with thrombus at the apex. His liver enzymes were deranged; ultrasound showed a structurally normal liver, with a dilated and fixed inferior vena cava. A liver biopsy was compatible with ischaemic hepatitis.A 16-slice computerized tomography pulmonary angiogram demonstrated multiple segmental pulmonary emboli, thrombus within the left atrial appendage (Fig. 1) and ventricle (Fig. 2). Intravenous heparin was administered and a left femoral embolectomy performed. Subsequent thrombophilia testing and stool cultures were normal. The leg embolus may have arisen from either the left ventricular or atrial appendage clot.Computerized tomography may successfully demonstrate left atrial appendage clot non-invasively and rapidly [1,2]. The left atrial appendage is the most common source of embolic clot, particularly in atrial fibrillation. Imaging of the appendage is usually by trans-oesophageal echocardiography and is used in situations such as cryptogenic stroke, prior to mitral valve valvuloplasty, or where cardioversion is contemplated. Cardiac magnetic resonance imaging may also detect left atrial appendage thrombus [3]. Images in cardiovascular medicineFig. 1 A 16-slice computerized tomography pulmonary angiogram demonstrating multiple segmental pulmonary emboli, thrombus within the left ventricle.Fig. 2A 16-slice computerized tomography pulmonary angiogram demonstrating multiple segmental pulmonary emboli, thrombus within the left atrial appendage.

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