A Neovascularized Left Atrial Mass

A Neovascularized Left Atrial Mass

Blog Article

Background.The discovery of a large left atrial mass through echocardiography obliges the clinician to perform a differential diagnosis to distinguish tumor from thrombus.The neovascularization of the mass could be helpful to predict the type of the malformation and whether it is in favour of a vacular tumour rather than a thrombus.Observation.

A 43-years-old man who had no cardiac antecedent reported that he have had dyspnea and palpitation since 10 months.The cardiac auscultation, revealed Bumper (Pre-Runner Bar) an irregular rhythm with diastolic murmur at the apex.The electrocardiogram showed an atrial fibrillation.The transthoracic echocardiography revealed a severe mitral stenosis with a huge left atrial mass, confirmed through transesophageal echocardiography.

After 4 weeks of an efficient anticoagulant treatment, the mass was still persistent in the echocardiography.So we decided to resect the mass and to achieve a mitral valve replacement.The preoperative coronarography showed neovascularization among the mass and fistula from the circumflex artery.Considering the characteristic of the mass (neovascularization and resistance to anticoagulant), we strongly suspected a vascular tumor especially myxoma, but L-Glutamine the histological exam revealed an organized thrombus.

Conclusion.Coronary neovascularization is a specific sign for left atrial thrombus in mitral stenosis, but surgery is the best way to confirm diagnosis.