Spontaneous right-sided microcavitations in a healthy adult

Spontaneous echo contrast (SEC) is frequently observed in patients with structural and functional cardiovascular abnormalities. Literature describes cases of SEC either from agglutination of red blood cells and plasma proteins or from microcavitations. SEC secondary to the former is an independent predictor of future thromboembolic events and is most commonly observed in the left atrium or left atrial appendage. Thus, many authors reason that left atrial SEC is an indication for initiating anticoagulant therapy. We report a rare case of right atrial SEC that was incidentally found during echocardiographic evaluation of isolated peripheral edema in a healthy adult with a structurally normal heart. At present, there are no studies to offer guidance for management of right atrial SEC. This case emphasizes a necessary area of future research. LEARNING POINTS: Cardiovascular implications of SEC. Diagnostic evaluation and management of SEC.