presence of LV band is strongly indicative of the accessory papillary muscle instead of pathologic entity.
Normally contractile adjacent LV wall help to exclude the mural thrombi.
Prominent mitral annular calcification Mitral annular calcification (MAC) is a chronic degenerative process that implies calcification on the mitral support structure. It usually appears as a bystander to other cardiac pathologies hindering surgical treatment and increasing morbidity and mortality. Aortic Valve Mass: Lamb’s Excrescences • Fine filamentous strands, Lambl excrescences, can be seen originating from the aortic valve of elderly patients. It is considered as a degenerative change on the surface of leaflets due to mechanical wear and tear. • Multiple adjacent excrescences may stick together and grow up to large, complex form called "giant Lambl's excrescence". Whether the excrescences may serve as a nidus for bacterial growth or cause a systemic embolism is controversial. In echo, it appears as very thin, delicate, lint-like mobile threads arising from the free borders or ventricular surfaces of aortic leaflets. Improving image quality increases to find this lesion. ■ The significance of Lambl's excrescences lies in the differential diagnosis from the vegetation of infective endocarditis. ■ It is challenging in most cases, and diagnostic decision-making often depends on clinical settings.
Lamble Excrescence
•Fine filamentous strands, Lamble excrescences, can be seen originating from the (1) valve of (2) patients.
•These structures can be differentiated from valvular vegetations by their characteristic "delicate" appearance in the absence of any clinical evidence of endocarditis .
Papillary fibroelastoma ■ benign avascular tumor arising from the normal endocardium, most frequently from the valvular endocardium. ■ it may be a hamartoma developing in a degenerative wear-and-tear process. ■ Characteristic numerous gelatinous papillary fronds of tumor surface consist of dense connective tissue core covered by endothelium. In echo, a small mobile tumor with fine frond-like surface attaches to the downstream side of the valve by a small stalk. Surgical resection is needed as it may cause a systemic embolism.
