J Korean Soc Echocardiogr.  1994 Dec;2(2):220-224. 10.4250/jkse.1994.2.2.220.

Mitral “Hole-in-one Embolus” Detected by Transesophageal Echocardiography During Cardiopulmonary Resuscitation: A Cases Report

• Lee BS
• Hwang SO
• Lim KS
• Lee KH
• Ryo KK
• Yoon JH
• Park KS
• Choe KH

• KMID: 2410452
• DOI: http://doi.org/10.4250/jkse.1994.2.2.220

Abstract

Mass detached partially or completely from left atrial wall, may produce systemic embolus. If embolus is too large and mitral stenosis is coincidentally present, emblous may obstruct inflow tract of the left ventricle and result in rapid decrease of cardiac output and sudden death subsequently. We experienced a 59-year-old male victim with sudden cardiac arrest from obstruction("hole-in-one embolus") of stenotic mitral valve by left atrial mass(ball thrombus). which was detected by transesophageal echocardiography during cardiopulmonary resuscitation.

Keyword

Left atrial mass; Ball thrombus; Cardiopulmonary resuscitation; Transesophageal echocardiography

MeSH Terms

Cardiac Output
Cardiopulmonary Resuscitation*
Death, Sudden
Death, Sudden, Cardiac
Echocardiography, Transesophageal*
Embolism
Heart Ventricles
Humans
Male
Middle Aged
Mitral Valve
Mitral Valve Stenosis

Figure

• 

  Fig. 1. 내원 1개월전에 시행된 심조음파 소견 a. Transthoracic parasternal short axis view상 좌심방 전벽에 붙어있는 echogenic mass(3.0×3.6cm) 가관잘된디. b. Transesophageal longitudinal view(caval-right atrial-left atrial view) 상 경흉 심초음파상관잘되었던 mass 가 좌심방 전벽에서 관잘된다.

• 

  Fig. 2. 심폐소생솔중 시행된 경식도 조음파 소견 a. Transesophageal four-chamber view. b. Left ventricular-left atrial two-chamber view. 승모판올 완전히펴|쇄하고 있는 mass(“hole-in-one embolus”) 가 관잘된다. 심펴|소생술(흉부압박)로 우심싫이 압박되어있다.

Reference

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