Severe mitral stenosis can cause which echocardiographic appearance?

Severe mitral stenosis can cause which echocardiographic appearance?

• A. Mural thrombus
• B. Calcification
• C. Pulmonary edema
• D. Spontaneous contrast

Answer: (D)

Severe mitral stenosis causes marked dilation of the left atrium with very slow, stagnant blood flow. That stasis leads to the development of spontaneous echo contrast, the smoke-like, dynamic echoes seen within the left atrium or left atrial appendage on echocardiography. This appearance reflects red blood cell aggregation and low-velocity flow, signaling high thromboembolic risk even before a solid thrombus forms. While mural thrombus can occur in a dilated, stagnant left atrium, the characteristic echocardiographic finding linked to severe MS is spontaneous contrast. Calcification relates to valve structure rather than this stasis pattern, and pulmonary edema is a clinical consequence of elevated pressures rather than a specific left atrial echo appearance.

Severe mitral stenosis causes marked dilation of the left atrium with very slow, stagnant blood flow. That stasis leads to the development of spontaneous echo contrast, the smoke-like, dynamic echoes seen within the left atrium or left atrial appendage on echocardiography. This appearance reflects red blood cell aggregation and low-velocity flow, signaling high thromboembolic risk even before a solid thrombus forms. While mural thrombus can occur in a dilated, stagnant left atrium, the characteristic echocardiographic finding linked to severe MS is spontaneous contrast. Calcification relates to valve structure rather than this stasis pattern, and pulmonary edema is a clinical consequence of elevated pressures rather than a specific left atrial echo appearance.