Cardiac LV Thrombus on Echocardiogram Short-Axis View (PSAX) 48 year old woman in ICU for acute ischemic limb. PMHx recent CHF, IV drug use. Thoughts on the pedunculated mass? What are the next POCUS steps in clarifying what it is? - Next steps - off axis imaging, other views, try colour to see if mass persists & maybe consider contrast agent. Check for akinetic segments. Looking for evidence of artefact vs thrombus - You have beautifully shown the lesion, and in the context of embolism, with it attached to an akinetic segment - it is overwhelmingly likely to be thrombus. If other things are being considered (principally vegetation, given IVDU, although it would be a v. odd place, and tumours) then the next tests are not POCUS: serial blood cultures, cardiac MRI, CT TAP are all of some value. But this will still very likely be thrombus. Dr. Marc-Andre Blier @ArcMandre #thrombus #Cardiac #LV #Echocardiogram #PSAX #clinical #cardiology
