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Case Reports
. 2016 Feb 15:2016:bcr2015211532.
doi: 10.1136/bcr-2015-211532.

When is a mass not a mass? An unusual presentation of prominent crista terminalis

Handi Salim  1 , Amitabh Palit  2 , Abdul Maher  3
Affiliations
Case Reports

When is a mass not a mass? An unusual presentation of prominent crista terminalis

Handi Salim et al. BMJ Case Rep. .

Abstract

This case report describes a patient in whom echocardiography showed borderline left ventricular hypertrophy and a mass adjacent to the right atrial wall. This naturally caused some concern as the differential diagnoses included that of a right atrial myxoma and further investigations were organised. A subsequent cardiac MRI revealed this thickening to be a prominent crista terminalis. The crista terminalis is a variant of normal anatomical structures within the right atrium, which mimics an atrial mass.

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Figures

Figure 1
Figure 1
Patient's ECG showing sinus rhythm with left ventricular hypertrophy.
Figure 2
Figure 2
Patient's echocardiograph, with a prominent structure in the right atrium (arrow). LA, left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle.
Figure 3
Figure 3
Early and late post gadolinium images confirming the presence of non-perfused structure in the right atrium (arrow).
Figure 4
Figure 4
A ‘stack’ of cines in the four-chamber plane demonstrating the anatomical relationships of the crista terminalis in the high right atrium.
Figure 5
Figure 5
Echocardiograph picture of normal heart.
See this image and copyright information in PMC

References

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