Spontaneous echo contrast (SEC) is often observed in patients with mitral stenosis, atrial fibrillation, cardiomyopathy, or a ventricular aneurysm [ ]. SEC is a smoke-like echo density observed on echocardiograms, and is caused by increased red blood cell aggregation during low-flow states. It is also a risk factor of thromboembolism [ ]. SEC can be observed in patients with severe ventricular dysfunction receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO). We present a case in which left ventricular-SEC (LV-SEC) was mistaken for a LV thrombus during VA-ECMO for severe LV dysfunction.
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