This case study is from the Cardiac Imaging Department, Hospital Clinic, Barcelona, Spain. A woman in her early 60s came to the emergency room with left hemiparesis and her medical history suggested several reasons for concern. She was a sufferer of rheumatic valve disease since childhood and had a history of valve surgeries. They used 3-D echo to clearly identify a small thrombus covering part of the prosthetic ring, which had not been completely clear in the 2-D echo.
Figure 1 from the guidelines, showing a side-by-side views of apical 4- and 2-chamber images, at rest and immediately post-exercise. In the four-chamber view, the left ventricle is shown on the left-hand side of the screen. With exercise, the LV cavity dilates (right quadrants) and there are regional wall motion abnormalities in the LAD territory.