Trombus

Thrombus is an aggregation of blood cells in which the blood flow becomes so slow that the blood solidifies. Thrombi may occur anywhere in the body. In this article, only intracardiac thrombi is highlighted. Thrombus is the most common source of cardiac embolism. At least 10-20% of all strokes/TIAs are of cardiac origin. Pulmonary embolism (90-95%) originates in the deep venous system of the lower extremities.

Intracardiac thrombi
Percentage	Location	Comment
55%	Left atrium	When atrial fibrillation is preferably in the LAA
25%	Left ventricular	In akinesia/aneurysms
10%	Art Valves	Often lethal
Remaining	Right sided	In VCSSP in coronary sinus In Grawitz tumor VCI Vegetation at TV
	Aorta	Atherosclerotic plaques

Examples

Video	Video
Mural thrombus apical septal	Mural thrombus apical inferior
Video	Video
Thrombus in RA	Mobile thrombus in LA from LAA

References

1. Hamer, J.P.M. “Cardiale massa’s”, in: Hamer/Pieper, ‘Praktische echocardiografie’, (2006), 1e druk 2e oplage, Houten, Bohn Stafleu van loghum, p198-200.

2. Pieper, P.G.. “Het hart als cardiale emboliebron”, in: Hamer/Pieper, ‘Praktische echocardiografie’, (2006), 1e druk 2e oplage, Houten, Bohn Stafleu van loghum, p.208-212.