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Case Reports
. 2021 Mar 4;5(3):ytab062.
doi: 10.1093/ehjcr/ytab062. eCollection 2021 Mar.

Multimodality cardiac imaging for management of a cardiac mass in the era of COVID-19: a case report

Pragya Ranjan  1 , Gina LaRocca  1 , Javier Sanz  1 , Lori Croft  1
Affiliations
Case Reports

Multimodality cardiac imaging for management of a cardiac mass in the era of COVID-19: a case report

Pragya Ranjan et al. Eur Heart J Case Rep. .

Abstract

Background: Atrial myxomas are the most common benign cardiac tumours. This case highlights an unusual presentation and complex management of a patient who was incidentally found to have a left atrial tumour concerning for a myxoma.

Case summary: A 54-year-old-woman presented with symptoms of nausea and vomiting and was found to have a left atrial mass incidentally in addition to a renal infarct. She was also found to have COVID-19 and the mass was initially thought to be a thrombus. With the help of multimodality imaging, it was determined that the mass was an atrial myxoma and she was started on short-term anticoagulation to prevent recurrent embolization. After 6 weeks of anticoagulation, she successfully underwent elective resection of the mass which was confirmed to be myxoma with superimposed thrombus.

Discussion: It is difficult to differentiate cardiac tumours from intracardiac thrombus and multimodality cardiac imaging is crucial to make an accurate diagnosis. While the treatment of atrial myxomas involves early surgical resection, it becomes more complicated with concurrent COVID-19 infection.

Keywords: Atrial mass; COVID-19; Cardiac MRI; Case report.

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Figures

Figure 1
Figure 1
Computed tomography with intravenous contrast (axial view) demonstrating (A) a left atrial mass and (B) left renal infarct.
Figure 2
Figure 2
(A) Two-dimensional transthoracic echocardiogram, Parasternal long-axis view: left atrial mass. (B and C) Two-dimensional transthoracic echocardiogram, Focused apical four-chamber view: a rounded, sessile left atrial mass attached to the interatrial septum.
Figure 3
Figure 3
(A) CINE FIESTA imaging, four chamber: a rounded mass in the left atrium. (B) T2-weighted imaging, two chamber: left atrial mass appears hyperintense in comparison to the surrounding myocardium, a finding consistent with oedema. (C) First-pass perfusion, two-chamber: mild, heterogenous pattern of perfusion of the mass is seen. (D) First-pass perfusion, four chamber: mild, heterogenous pattern of perfusion of the mass is seen. (E) Late gadolinium enhancement imaging, two chamber: heterogeneous pattern of enhancement. (F) Late gadolinium enhancement imaging, four chamber: heterogeneous pattern of enhancement.
Figure 4
Figure 4
(A) H&E stained slide demonstrating atrial myxoma. (B) Calretinin stained slide demonstrating atrial myxoma.
None
None
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Comment on

References

    1. Kirkpatrick JN, Mitchell C, Taub C, Kort S, Hung J, Swaminathan M.. ASE statement on protection of patients and echocardiography service providers during the 2019 novel coronavirus outbreak. J Am Coll Cardiol 2020;23:3078–3084. - PMC - PubMed
    1. Bikdeli B, Madhavan MV, Jimenez D, Chuich T, Dreyfus I, Driggin E. et al. COVID-19 and thrombotic or thromboembolic disease: implications for prevention, antithrombotic therapy, and follow-up. J Am Coll Cardiol 2020;75:2950–2973. - PMC - PubMed
    1. Reynen K. Frequency of primary tumors of the heart. Am J Cardiol 1996;77:107. - PubMed
    1. McAllister HA Jr. Primary tumors and cysts of the heart and pericardium. Curr Probl Cardiol 1979;4:1–51. - PubMed
    1. Gaasch WH, Vander Salm TJ.. Cardiac tumors. In: Shah S, Yeon SB (eds.), UpToDate. Waltham, MA, 2020. https://www-uptodate-com.eresources.mssm.edu/contents/cardiac-tumors?sea....

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