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Ivan Fauchère, Rolf Jenni, Felix C. Tanner, Triple heart image: one heart beats as three, European Journal of Echocardiography, Volume 12, Issue 8, August 2011, Page 639, https://doi.org/10.1093/ejechocard/jer081
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Extract
A 69-year-old patient with dilated cardiomyopathy and severe mitral regurgitation due to annulus dilatation was evaluated for mitral valve reconstruction. Transesophageal echocardiography showed a surprising finding with a triplication of all cardiac structures, demonstrating well-separated ghost images, most evident at the level of the aortic valve (Panel A; Loops 1 and 2) and mitral valve (Panel B; Loops 3 and 4). The triplication was observed in all the views of the transesophageal study including the transgastric position (Panel C; Loops 5 and 6). In contrast, no triplication occurred in any of the transthoracic images. Triplication was also observed with colour Doppler images (Loops 2, 4, and 6) and persisted irrespective of changes in position and angle of the transducer, depth of the field, or respiratory manoeuvers, making it difficult to determine the original image. The triplicated structures were located at similar angles and distance from the transducer, suggesting refraction as the cause of the artefact.