Raut MS, Maheshwari A, Shad S. Real and pseudo clot in left atrial appendage. Ann Card Anaesth. 2014;17:42–3.

Article  PubMed  Google Scholar 

• Quien MM, Saric M. Ultrasound imaging artifacts: how to recognize them and how to avoid them. Echocardiography. 2018;35:1388–401. This article provides more understanding of the physics behind the artifacts. In addition to ours, it helps to establish a good understanding of echocardiographic artifacts.

Güvenç TS, Velibey Y, Güzelburç Ö, Çinier G, Çetin Güvenç R, Yıldırımtürk Ö. Reverberation and multiple shadow artifacts recorded from patients with intra-pericardial centrifugal continuous-flow left ventricular assist devices. Echocardiography. 2017;34:1508–11.

Article  PubMed  Google Scholar 

Bertrand PB, Levine RA, Isselbacher EM, Vandervoort PM. Fact or artifact in two-dimensional echocardiography: avoiding misdiagnosis and missed diagnosis. J Am Soc Echocardiogr. 2016;29:381–91.

Article  PubMed  PubMed Central  Google Scholar 

Bernard S, Yucel E. Paravalvular leaks—from diagnosis to management. Curr Treat Options in Cardiovasc Med. 2019;21:67.

Article  Google Scholar 

Le HT, Hangiandreou N, Timmerman R, Rice MJ, Smith WB, Deitte L, Janelle GM. Imaging artifacts in echocardiography. Anesth Analg. 2016;122:633–46.

Article  PubMed  Google Scholar 

Zoghbi WA, Asch FM, Bruce C, Gillam LD, Grayburn PA, Hahn RT, Inglessis I, Islam AM, Lerakis S, Little SH, et al. Guidelines for the evaluation of valvular regurgitation after percutaneous valve repair or replacement: a report from the American Society of Echocardiography developed in collaboration with the Society for Cardiovascular Angiography and Interventions, Japanese Society of Echocardiography, and Society for Cardiovascular Magnetic Resonance. J Am Soc Echocardiogr. 2019;32:431–75.

Article  PubMed  Google Scholar 

Cruz-Gonzalez I, Antunez-Muiños P, Lopez-Tejero S, Sanchez PL. Mitral paravalvular leak: clinical implications, diagnosis and management. J Clin Med. 2022;11.

Oren O, Blankstein R, Bhatt DL. Addressing imaging pitfalls to reduce cardiovascular disease misdiagnosis in patients with breast cancer following reconstruction. JAMA Cardiol. 2022;7:123–5.

Article  PubMed  Google Scholar 

Duarte Ow J, Hemu M, Yakupovich A, Bhatt P, Gaddam H, Prabhu N, Fughhi I, Cobleigh M, Tracy M, Fogg L, et al. Influence of breast reconstruction on technical aspects of echocardiographic image acquisition compared with physician-assessed image quality. Cardio-Oncology. 2019;5:17.

Article  PubMed  PubMed Central  Google Scholar 

Makhija N, Sharma A, Magoon R, Kumar A. Surgical-conundrum of a hiding ‘bullet’: echocardiographic artefact clues the concealed fact! Indian J of Anaesth. 2021;65:412–3.

Article  Google Scholar 

Upadhyaya K, Ugonabo I, Satam K, Hull SC. Echocardiographic evaluation of the thoracic aorta: tips and pitfalls. AORTA. 2021;9:001–8.

Article  Google Scholar 

Baloria KA, Dhir A, Pillai B, Selot N. Aortic dissection: to be or not to be? Ann Card Anaesth. 2013;16:126–8.

Article  PubMed  Google Scholar 

Bennett JM, Sileshi B. Incorrect diagnosis of type A aortic dissection attributed to motion artifact during computed tomographic angiography: A case report. A&A Pract. 2017;9:254–7.

Google Scholar 

D’Amico G, Mojoli M, Buja P, Tarantini G. Left atrial appendage closure: beyond the artifact. J Cardiovasc Med. 2016;17:e171–3.

Article  Google Scholar 

Maltagliati A, Pepi M, Tamborini G, Muratori M, Celeste F, Doria E, Galli C. Usefulness of multiplane transesophageal echocardiography in the recognition of artifacts and normal anatomical variants that may mimic left atrial thrombi in patients with atrial fibrillation. Ital Heart J. 2003;4:797–802.

PubMed  Google Scholar 

Hussey PT, Mering G, Nanda NC, Ahmed MI, Addis DR. Echocardiography for extracorporeal membrane oxygenation. Echocardiography (Mount Kisco, N.Y.). 2022;39:339–70.

Platz E, Lattanzi A, Agbo C, Takeuchi M, Resnic FS, Solomon SD, Desai AS. Utility of lung ultrasound in predicting pulmonary and cardiac pressures. Eur J Heart Fail. 2012;14:1276–84.

Article  PubMed  Google Scholar 

Rivas-Lasarte M, Solé-González E, Álvarez-García J, Maestro A, Garcia-Picart J, Roig E, Cinca J. Dynamic correlation between cardiac filling pressures and b-lines in a lung ultrasound: a pilot study. J Card Fail. 2021;27:379–81.

Article  PubMed  Google Scholar 

Uygur B, Kahraman S, Celik O, Erturk M. A rare complication of mitral valve replacement: iatrogenic aortic valve perforation. J Clin Ultrasound. 2019;47:175–7.

Article  PubMed  Google Scholar 

Tchelepi H, Ralls PW. Color comet-tail artifact: clinical applications. Am J Roentgenol. 2009;192:11–8.

Article  Google Scholar 

De Vos L, De Herdt V, Timmermans F. Misdiagnosis or missed diagnosis: digging out the “near-field clutter” artifact in a patient with stroke. CASE (Phila). 2020;4:2–6.

Google Scholar 

Liang Y, Alvis B, Rice MJ, Shaw AD, Deitte LA, Eagle S. A near-field clutter artifact mimicking pulmonary thrombus during transesophageal echocardiography. Anesth Anal. 2016;123:831–3.

Article  Google Scholar 

Orlowska M, Ramalli A, Bézy S, Voigt JU and D’hooge J. Singular value decomposition filtering for high frame rate speckle tracking echocardiography. 2021 IEEE International Ultrasonics Symposium (IUS). 2021; pp.1–4, https://doi.org/10.1109/IUS52206.2021.9593850.

Sjoerdsma M, Bouwmeester S, Houthuizen P, van de Vosse FN, Lopata RG. A spatial near-field clutter reduction filter preserving tissue speckle in echocardiography. IEEE Trans Ultrason Ferroelectr Freq Control. 2020;68:979–92.

Article  Google Scholar 

Pergola V, Cabrelle G, De Conti G, Barbiero G, Mele D, Motta R. Challenging cases of aortic prosthesis dysfunction, the importance of multimodality imaging, a case series. Diagnostics. 2021;11:2305.

Article  PubMed  PubMed Central  Google Scholar 

Kerr DM, Middleton WD. Reflections on the ultrasound mirror image artifact. Ultrasound Q. 2020;36:287–99.

Article  PubMed  Google Scholar 

Malik ZM, Lau C, Skubas NJ. Aortic dissection: true or false? A&A Pract. 2018;11:140–3.

Article  Google Scholar 

Wu W, Zhang N, Hsi DH, Niu L, Jiang Y, Wang Y, Zhu Z, Wang H. Recognition of ultrasound artifact mimicking pulmonary artery dissection in patients with heart disease. Biomed Res Int. 2019;2019:4919416.

PubMed  PubMed Central  Google Scholar 

Ayan M, Vallurupalli S. Two aortic valves in the parasternal long-axis view: aortic dissection or artifact? Echocardiography. 2018;35:121–2.

Article  PubMed  Google Scholar 

Kapil A, Basha A, Yadav S. Double aortic valve sign in aortic dissection. J Emerg Med. 2022;62:397–8.

Article  PubMed  Google Scholar 

Ochi Y, Yamasaki N, Baba Y, Kawaguchi J, Nakashima Y, Ueta M, Hirota T, Kubo T, Kitaoka H. A single atrial septal defect masquerading as multiple defects due to a refraction artifact – a cautionary note. J Cardiol Cases. 2020;22:55–8.

Article  PubMed  PubMed Central  Google Scholar 

Prabhu SJ, Kanal K, Bhargava P, Vaidya S, Dighe MK. Ultrasound artifacts: classification, applied physics with illustrations, and imaging appearances. Ultrasound Q. 2014;30:145–57.

Article  PubMed  Google Scholar 

Sano M, Urushida T, Kaneko Y, Sakakibara T, Narumi T, Iguchi K, Suwa K, Naruse Y, Maekawa Y. Pseudothrombotic appearance on pulmonary valve by intracardiac echocardiography during atrial fibrillation ablation. J Arrhythm. 2021;37:448–9.

Article  PubMed  Google Scholar 

Devarakonda BV, Babu S, Pan S, Gadhinglajkar S, Thomas D, Jagadish A. Three guidewires inside the internal jugular vein as a result of side lobe artifacts during ultrasound-guided central venous cannulation: importance of image depth and focal point. J Cardiothorac Vasc Anesth. 2021;35:1905–6.

Article  PubMed  Google Scholar 

Yastrebov K, Brunel L, Paterson HS, Williams ZA, Wise IK, Burrows CS, Bannon PG. Implantation of Impella CP left ventricular assist device under the guidance of three-dimensional intracardiac echocardiography. Sci Rep. 2020;10:17485.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Bertrand PB, Grieten L, Smeets CJ, Verbrugge FH, Mullens W, Vrolix M, Rivero-Ayerza M, Verhaert D, Vandervoort PM. The figure-of-eight artifact in the echocardiographic assessment of percutaneous disc occluders: impact of imaging depth and device type. Echocardiography. 2015;32:557–64.

Article  PubMed  Google Scholar 

Kassi M, Rosenbaum AN, Wiley BM, Behfar A. Novel use for intracardiac echocardiography: evaluation of patients with continuous flow left ventricular assist devices. JACC Cardiovasc Imaging. 2019;12:363–6.

Article  PubMed  Google Scholar 

Cozzarin A, Marambio GM, Ferreiro DE, Gonda MF, Balletti LR, Medawar MH, Gagliardi JA, Cianciulli TF. Detection of angiographically significant coronary obstruction using resting transthoracic coronary Doppler echocardiography. J Echocardiogr. 2018;16:139–46.

Article  PubMed  Google Scholar 

Gavazzoni M, Zuber M, Taramasso M, Maisano F, Jenni R. A double-envelope mitral inflow spectral Doppler profile after MitraClip. J Cardiothorac Vasc Anesth. 2021;35:3440–4.

Article  PubMed  Google Scholar 

Kamaya A, Tuthill T, Rubin JM. Twinkling artifact on color Doppler sonography: dependence on machine parameters and underlying cause. AJR Am J Roentgenol. 2003;180:215–22.

Article  PubMed  Google Scholar 

Tsao T-F, Wu Y-L, Yu J-M, Kang R-J, Tseng Y-H, Huang H-H, Hung S-W, Gueng M-K, Lin Y-C, Tyan Y-S, et al. Color Doppler twinkling artifact of calcified cardiac valves in vitro: a not well known phenomenon in echocardiography. Ultrasound Med Biol. 2011;37:386–92.

Article  PubMed  Google Scholar 

Wu SP, Huang YJ, Tsao TF, Tyan YS, Su CH. An in vitro study of guidewire-related color Doppler twinkling artifacts in echocardiography. J Med Ultrasound. 2018;26:200–4.

Article  PubMed  PubMed Central  Google Scholar 

Bennett JM, Estrada JC, Shoemaker MB, Pretorius M. Twinkling artifact associated with guidewire placement. Anesth Analg. 2015;121.

Zhao BW, Yang Y, Pan M, Li P, Wang B, Tang FG. Color Doppler twinkling artifact in fetuses with echogenic intracardiac foci: echocardiographic observation and clinical significance. Ultrasound Obstet Gynecol. 2010;35:548–51.

Article  CAS  PubMed