Which echo finding is commonly associated with severe mitral stenosis?

Which echo finding is commonly associated with severe mitral stenosis?

• A. Mural thrombus
• B. Spontaneous contrast
• C. Pulmonary embolism
• D. Aortic dissection

Answer: (B)

Severe mitral stenosis slows blood flow through the left atrium, causing marked atrial dilation and stasis. This sluggish flow promotes red blood cell aggregation, which on echocardiography appears as spontaneous echo contrast—often described as a smoky or swirling echo within the left atrium. This finding is a hallmark of blood stasis and signals a high risk of thrombus formation and subsequent embolization, making spontaneous echo contrast the most characteristic echo finding associated with severe MS. While mural thrombus can occur, spontaneous contrast is the classic and most commonly observed sign of the stasis driving thromboembolic risk. Pulmonary embolism and aortic dissection are not typical echo findings linked to severe mitral stenosis.

Severe mitral stenosis slows blood flow through the left atrium, causing marked atrial dilation and stasis. This sluggish flow promotes red blood cell aggregation, which on echocardiography appears as spontaneous echo contrast—often described as a smoky or swirling echo within the left atrium. This finding is a hallmark of blood stasis and signals a high risk of thrombus formation and subsequent embolization, making spontaneous echo contrast the most characteristic echo finding associated with severe MS. While mural thrombus can occur, spontaneous contrast is the classic and most commonly observed sign of the stasis driving thromboembolic risk. Pulmonary embolism and aortic dissection are not typical echo findings linked to severe mitral stenosis.