Spontaneous echo contrast/ Dynamic intra cardiac echo

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Parasternal long axis view is seen. Left atrium is enlarged. Mitral valve is rheumatic with anterior mitral leaflet (the upper one) showing hockey stick deformity. A swirling pattern is seen in the left atrium. This is called spontaneous echo contrast (SEC). It is also called dynamic intracardiac echo (DICE). This occurs in conditions of blood stasis and is due to aggregation of cellular components of blood. Here, it occurred in the left atrium due to mitral stenosis and atrial fibrillation. Spontaneous echo contrast in the left atrium is associated with increased risk of thromboembolism and cerebrovascular accident.