Koh Choong Hou’s Post

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Cardiologist, Nobel Heart Centre | Adj Asst Professor, Duke-NUS Medical School | Visiting Consultant, National Heart Centre Singapore & Changi Aviation Medical Centre | Flight Surgeon

No, that is not a worm inside the heart. 🪱 The mobile, vermiform structure that you’re seeing is a left ventricular thrombus… or simply put, a clot in the heart. It formed due to areas of stasis within the heart, secondary to poor contractility of the heart muscles. In those areas where blood tend to “puddle together”, tiny, or sometimes huge, clots can form (a contributing factor to Virchow’s triad). So what? 🤷🏻♂️ Well, those clots can fly off and embolize elsewhere. And when they do, it’s a clinical disaster. It can choke up vessels in the brain 🧠(stroke), eyes 👀(blindness) or even intestines (ischaemic bowel). That’s why stroke neurologists routinely work up their patients with a 2D echocardiogram. It’s to pick up uncommon causes such as this. A clot in the heart. Sometimes the clot forms in the upper chambers of the heart due to atrial fibrillation. The mechanism is similar. However, those can only be picked up by transesophageal echocardiogram, a more specialized modality when a probe needs to be introduced into the gullet to obtain cardiac images from inside the body. 📸 “Worms” in the heart can be dangerous. We, as echocardiologists, work closely with the stroke neurologists to ensure conditions like cardioembolic sources are not missed, and if detected, are treated promptly. #lvthrombus #cardioembolism #stroke #echocardiogram #echo

Alex Belov

AI Business Automation & Workflows | Superior Website Creation & Maintenance | Podcast

5mo

Incredible and scary at the same time!

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