Heart CVS

Large clot seen in ventricle

This young adult male patient underwent echocardiography to rule out cardiac pathology for pyrexia. Ultrasound image shows a large thrombus adherent to the wall of the left ventricle. The thrombus is seen as an echogenic, well defined mass in the ventricular lumen. Cardiac thrombi are seen following ventricular dysfunction, cardiomyopathy, myocardial infarction and ventricular aneurysm. Ultrasound image courtesy of Dr. Prasenjeet Singh, Delhi, India.


Reference: http://pediatrics.aappublications.org/cgi/content/full/107/2/421 (free article)

Chordae tendinae calcification

Echocardiography of the heart in this patient shows calcification of the chordae tendinae in the right ventricle. The causes of such calcific lesions of the chordae tendinae include acute or sub-acute bacterial endocarditis. These lesions may cause weakening and even rupture of the chordae. The chordae tendinae are string like fibrous chords that connect the papillary muscles to the borders of the tricuspid and mitral valves. Ultrasound image courtesy of Shlomo Gobi, Israel.




Ebstein anomaly

This adult patient presented with dyspnoea and palpitation. Echocardiography and Color Doppler imaging of the heart revealed apically displaced tricuspid valve with resultant atrialization of a major part of the right ventricle. There was also evidence of tricuspid regurgitation (image on right- Color Doppler). The right ventricle and the right atrium appear enlarged. These ultrasound images suggest Ebstein anomaly with tricuspid regurgitation. Both images courtesy of Dr. Vikas Arora, MD, India.




Rhabdomyoma of heart (cardiac Rhabdomyoma) in left ventricle

Sonography of cardiac masses

These ultrasound images of the heart show Rhabdomyoma of the left ventricle, measuring 10 mm. in size. The mass is seen as an echogenic (hyperechoic), well-defined mass of 10 mm., in the upper part of the interventricular septum. The patient is a neonate with proven diagnosis of the disease Tuberous sclerosis. Earlier sonography (not shown here) showed considerable obstruction to the left ventricular outflow tract. Rhabdomyoma is one of few rare tumours of the heart, seen in 1 in 10,000 births and are usually benign. Ultrasound image courtesy of Mr. Shlomo Gobi, Israel.


Reference: http://www.thefetus.net/page.php?id=506


Artificial cardiac Pacemaker

Sonography of the heart (echocardiography) was done in this patient of congestive cardiac failure (CCF) or congestive heart failure (CHF). This patient had undergone implantation of dual chamber pacemakers into the heart. The pacemaker electrodes are seen as hyperechoic linear echoes within the heart. Ultrasound images are courtesy of Mr. Shlomo Gobi, Israel.


Reference: http://en.wikipedia.org/wiki/Artificial_pacemaker


Dissecting aneurysm of abdominal aorta

This color Doppler image (left) and ultrasound images show a cross section of the abdominal aorta with the separated intimal flap seen as an echogenic linear structure in the lumen of the aorta. Color Doppler image shows flow on both sides of the intimal flap suggesting a dissecting aortic aneurysm/ aortic dissection. Images are courtesy of Ravi Kadasne, MD, UAE.


Reference: /article/756835-overview (free article and images)

( excellent article)


B-mode and contrast enhanced B-mode echocardiography (cardiac ultrasound) along with 3-D/ 4-D echo/ ultrasound show an aneurysm of the apical part of left ventricle (blue arrows). This type of aneurysm is the result of myocardial infarction involving the left ventricle resulting in weakening of the myocardium causing out-pouching or aneurysm formation in the apical region with each contraction or systole of the left ventricle.

Apical aneurysm of the left ventricle is the commonest site of aneurysm formation as a sequelae to myocardial infarction. (Images are courtesy of Billy Cathey).


D/d: pseudo-aneurysm of the heart--> pseudo-aneurysm results from rupture of the myocardium following a myocardial infarction with formation of a sac lined by pericardium. This type of lesion has no myocardial tissue lining the sac.

True aneurysms (like the case here), have lining of myocardium which can be traced to the adjacent part of the ventricle.


1) Aneurysm of the left ventricle

2) What is an aneursym of the ventricle

3) pseudo-aneurysm of the Left ventricle



Above echocardiography (echo) video shows MS (mitral stenosis) with MR (mitral regurgitation) with mild AR or aortic regurgitation.

= severe rheumatic mitral stenosis evident with mitral valve orifice markedly reduced in size (see the MS jet on color Doppler study)

= markedly enlarged left atrium due to severe mitral stenosis

= also evident is an eccentric mitral regurgitation (MR jet on color Doppler)

= a mild AR is also present (AR jet on color Doppler ultrasound)

This patient was due for surgery  for mitral valvular disease.

Ultrasound video (echo) taken using Toshiba Nemio XG ultrasound system by Joe Antony, MD

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