Fact-sheet: Cardiac thrombus
Updated on 10/05/2016 at 2:02 PM
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Definition
Endocavitary thrombus, with variable location in any chamber depending on etiology.
Single or multiple.
Variable size and attachment.
Nodular or plaque-like shape.
Various etiologies:
- Ischemic, arrhythmic, or dilated cardiomyopathy
- Coagulopathy
- Infectious
- Exogenous endocavitary material...
Clinical features
Organ ischemia syndrome if peripheral embolism,
asymptomatic if purely endocavitary.
Ultrasound
Echogenic structure present throughout the cardiac cycle in two orthogonal planes
CT
Spontaneously hyperdense structure, not enhanced at any injection phase
MRI
Structure with T1 and T2 hyposignal, variable depending on thrombus age, not enhanced at the different injection phases.
Cine sequences with injection are useful to assess the dynamic character
Management
Long-term effective anticoagulation, with the primary goal of reducing embolic risk.
Differential diagnosis
Any endocavitary mass syndrome should raise suspicion for a primary or secondary cardiac tumor. Pitfall images: - False tendon - Papillary muscle partial volume effect - Flow-related images