Transesophageal echocardiographic evidence for acute right atrial dysfunction

We describe the clinical course and echocardiographic findings of a 64-year -old man who was hospitalized with an infarction. of the inferior myocardia l wall of 5 days' evolution and extension. to the right ventricle. Transeso phageal echocardiography showed biventricular inferior dyssynergia and akin esis of the right atrial wall. One thrombus was visible in the right atrial appendage, and another crossed the foramen ovale and reached the mitral va lve. After the patient received anticoagulant agents, transesophageal studi es showed the disappearance of atrial thrombi, as well as recuperation of r ight atrial movement and active participation of atrial contraction in righ t ventricular filling. The findings of these serial echocardiograms support the existence of ischemic right atrial stunning manifested by wall akinesi s that favored slow atrial flow and the formation of thrombi.