An unusual presentation of bi-atrial cardiac masses - thrombus or myxoma ? A case report and review of literature

Lu Hou Tee, Chun Ngok Choy, Norliza Othman, Rusli Bin Nordin, Tech Hwa Goh

Research output: Contribution to journalArticleOther

Abstract

The differentiation between cardiac thrombus and myxoma is not always straightforward and the exact diagnosis is important because of its distinct treatment strategy. Our case report highlights the diagnostic challenge of differentiating a cardiac mass between thrombus and myxoma, despite the advent of modern imaging modalities. Wedescribed a 54-year-old man, with severe mitral stenosis and atrial fibrillation presented with left and right atrial masses. The TTE, TEE and CMR revealed a large, free-floating, homogeneous right atrial mass typical of thrombus, and a left atrial mass adhered to inter-atrial septum resembling atrial myxoma. The presence of risk factors, and the morphology, location and avascular characteristics of the cardiac masses made thrombi the most likely diagnosis. However, the cardiac masses were not regressed following empirical anticoagulation, possibly because of poor compliance. Fortunately, despite subtherapeutic anticoagulation and opted against surgical intervention, our patient did not demonstrate any thromboembolic events after the diagnosis of cardiac masses was established two and half years ago.
Original languageEnglish
Pages (from-to)1 - 10
Number of pages10
JournalExperimental and Clinical Cardiology
Volume20
Issue number9
Publication statusPublished - 2014

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