DOI: 10.36347/sjams.2018.v06i03.019

Pages: 904-907

Rheumatic mitral stenosis is common clinical problem in India. Patients with mitral stenosis are associated with an increased risk of thromboembolism and are a major cause of morbity and mortality. Spontaneous echo contrast formation in LA and left atrial appendage (LAA) is not an uncommon finding in these patients. The clinical implications of such LA/LAA spontaneous echo contrast reflect its association with LA/LAA thrombus formation and subsequent systemic embolic phenomenon. There are various factors which determine the individual risk for development of the left atrial clot/ spontaneous echo contrast and thromboembolism in patients with rheumatic mitral valve, which include AF, left atrial size, duration of symptoms, severity of mitral stenosis, and left atrial appendages function. Most of which are interrelated and there relative importance has been investigated in nonvalvular AF or in heterogenous population of rheumatic heart disease. Hence this study was conducted on homogenous population of 100 consecutive patients with mitral stenosis attending the department of cardiology and were studied by transthoracic and transoesophageal echo-Doppler techniques. The study concluded that not only severity of mitral stenosis but various clinical and echocardiograhic variables influence the prevalence of left atrial spontaneous echo contrast and embolism independently, patients with mitral stenosis who develop embolic phenomenon have invariably, left atrial spontaneous echo contrast and/or left atrial clot. Detection of left atrial spontaneous echo contrast and/or left atrial clot by TEE will, per se, identify candidates , at high risk for thromboembolism, and thus for the treatment with oral anticoagulants or antiplatelets.