Left Atrial Spontaneous Echo Contrast (SEC)

Left atrial spontaneous echo contrast (SEC) is an echogenic, smoke-like swirling of aggregated red blood cells suggestive of stasis. This sign confers an increased risk of thrombosis in the left atrium and/or left atrial appendage. We most commonly see SEC on transesophageal echocardiography (TEE) in patients with atrial arrhythmias like atrial fibrillation and mitral valve pathologies like mitral stenosis or a prior valve replacement. It’s important that the echocardiographer carefully examines adjacent structures for clots and considers pharmacologic anticoagulation for patients with SEC.

In the video above, the large chamber is the left atrium (LA), the valve in the center of the clip is the aortic valve (AoV), and the valve just to the left of that is the mitral valve (MV). You can clearly see the swirling pattern of SEC in the atrium. 🙂

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