Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
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
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 by National 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
Processing time: 173 Days and 20.5 Hours
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.

Keywords: Endocardial fibroelastosis; Three-dimensional echocardiography; Contrast echocardiography; Thrombosis; Left ventricle; Case report

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.