J Cardiovasc Ultrasound.  2010 Dec;18(4):154-156. 10.4250/jcu.2010.18.4.154.

Left Atrial Mass with Stalk: Thrombus or Myxoma?

• Jang KH
• Shin DH
• Lee C
• Jang JK
• Cheong S
• Yoo SY

• KMID: 2177319
• DOI: http://doi.org/10.4250/jcu.2010.18.4.154

Abstract

A 63-year-old female was presented to emergency room with an abdominal pain. The patient had moderate mitral valve stenosis and atrial fibrillation. Abdominal computed tomography revealed right renal infarction. Transthoracic echocardiography showed a large mobile mass in the left atrium. Transesophageal two-and three-dimensional echocardiography showed a large mobile ovoid mass with a narrow stalk attached to the left atrial septum. It was thought to be a myxoma rather than thrombus. Anticoagulation with heparin was continued. When the operation was performed, there was no mass in the left atrium. It must be a thrombus and melt away.

Keyword

Left atrium; Thrombus; Myxoma; Stalk; Atrial fibrillation

MeSH Terms

Abdominal Pain
Atrial Fibrillation
Atrial Septum
Echocardiography
Echocardiography, Three-Dimensional
Emergencies
Female
Heart Atria
Heparin
Humans
Infarction
Middle Aged
Mitral Valve Stenosis
Myxoma
Thrombosis
Heparin

Figure

• 

  Fig. 1 Transthoracic echocardiographic image in the apical 4-chamber view showing left atrial mass indicated by arrow. LV: left ventricle, RV: right ventricle.

• 

  Fig. 2 Two-dimensional transesophageal echocardiographic image showing a large (4 cm×2.5 cm), ovoid and heterogeneous mass (large arrow) in left atrium attached with a long narrow stalk (small arrow) to the anteroseptal wall of the left atrium. LA: left atrium, RA: right atrium.

• 

  Fig. 3 Three-dimensional transesophageal echocardiographic image showing a more definite connection via a long stalk (small arrow) between the mass (large arrow) and left atrial wall. LA: left atrium, LV: left ventricle, RA: right atrium, Ao: aorta.

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  Fig. 4 Gross pathologic specimen of stenotic mitral valve. There was no mass or thrombus in the left atrium.

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