TY - JOUR
T1 - An unusual presentation of bi-atrial cardiac masses - thrombus or myxoma ? A case report and review of literature
AU - Tee, Lu Hou
AU - Choy, Chun Ngok
AU - Othman, Norliza
AU - Nordin, Rusli Bin
AU - Goh, Tech Hwa
PY - 2014
Y1 - 2014
N2 - 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.
AB - 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.
UR - http://cardiologyacademicpress.com/soap/pdf/delme_2542_540f7d165d4897.83350089.pdf
M3 - Article
SN - 1205-6626
VL - 20
SP - 1
EP - 10
JO - Experimental and Clinical Cardiology
JF - Experimental and Clinical Cardiology
IS - 9
ER -