Sun LJ, Li Y, Qiao W, Yu JH, Ren WD. Incremental value of three-dimensional and contrast echocardiography in the evaluation of endocardial fibroelastosis and multiple cardiovascular thrombi: A case report. World J Clin Cases 2021; 9(14): 3365-3371 [PMID: 34002146 DOI: 10.12998/wjcc.v9.i14.3365]
Corresponding Author of This Article
Wei-Dong Ren, PhD, Chief Physician, Department of Ultrasound, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang 110004, Liaoning Province, China. renweidong3@163.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 16, 2021; 9(14): 3365-3371 Published online May 16, 2021. doi: 10.12998/wjcc.v9.i14.3365
Incremental value of three-dimensional and contrast echocardiography in the evaluation of endocardial fibroelastosis and multiple cardiovascular thrombi: A case report
Li-Juan Sun, Ying Li, Wei Qiao, Jia-Hui Yu, Wei-Dong Ren, Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Li-Juan Sun, Department of Ultrasound, The First Hospital of Qinhuangdao, Qinhuangdao 066000, Hebei Province, China
Author contributions: Sun LJ and Li Y equally contributed to this work; Sun LJ, Li Y and Ren WD participated in the design of the study; Sun LJ and Yu JH collected clinical data; Ren WD, Qiao W and Li Y performed echocardiographic examinations and collected the images; Sun LJ wrote the manuscript; Ren WD revised the manuscript; all authors read and approved the final manuscript.
Supported byNational Natural Science Foundation of China, No. 81571686.
Informed consent statement: Informed consent was obtained from the patient and the patient’s parents.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei-Dong Ren, PhD, Chief Physician, Department of Ultrasound, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang 110004, Liaoning Province, China. renweidong3@163.com
Received: November 6, 2020 Peer-review started: November 6, 2020 First decision: January 17, 2021 Revised: February 3, 2021 Accepted: March 10, 2021 Article in press: March 10, 2021 Published online: May 16, 2021
Abstract
BACKGROUND
Endocardial fibroelastosis (EFE) is a rare heart disease characterized by thickening of the endocardium caused by massive proliferation of collagenous and elastic tissue, usually leading to impaired cardiac function. Multimodality cardiovascular imaging for the evaluation of EFE with thrombi is even rarer.
CASE SUMMARY
We report a rare case of EFE associated with multiple cardiovascular thrombi. Three-dimensional (3D) and contrast echocardiography (CE) were used to assess ventricular thrombi. Anticoagulant therapy was administered to eliminate the thrombi. The peripheral contrast-enhanced thrombi with the highest risk were dissolved with anticoagulant therapy at the time of reexamination, which was consistent with the presumption of fresh loose thrombi.
CONCLUSION
This new echocardiography technique has a great advantage in the diagnosis and treatment of EFE. On the basis of conventional echocardiography, 3D echocardiography is used to display the position, shape, and narrow base of the thrombus. CE does not only help to confirm the diagnosis of thrombus, but also determines its risk.
Core Tip: We report a rare case of endocardial fibroelastosis with multiple thrombi of the left ventricle, abdominal aorta, common iliac artery, and renal artery occlusion diagnosed using multimodality cardiovascular imaging. The incremental value of three-dimensional and contrast echocardiography in clinical diagnosis of thrombi is explained.
