A 68-year-old female patient presented with increased effort dyspnea and pretibial edema for a month. Our patient did not have a history of heart failure or myocardial infarction. Physical examination revealed bilateral crepitate rale in basal areas of lungs and bilateral pretibial edema, high-pitched systolic murmur heard in the right lower sternal region. Patient's electrocardiogram was normal except incomplete right bundle branch block and the chest roentgenogram demonstrated the infiltrations in basal areas of lungs. All laboratory tests of the patient are in normal limits. An echocardiography planned for further diagnosis and treatment. It was detected a mobile 20.7 × 22.9 mm cystic circular mass attached to atrial side of septal tricuspid leaflet, which was prolapsing into right atrium during systole and the right ventricle during diastole (Figures 1 and 2 and Movies S1-S3). Left and right ventricle functions were normal.Doppler echocardiography showed mild and moderate tricuspid regurgitation without obstruction in the right ventricular inflow. For further examination of the mass, transoesophageal echocardiography and three-dimensional transoesophageal echocardiography were performed (Figures 1 and 2, Movie S4). The mass had a thin wall and an ecolucent core. The findings, in this case, showed the essential role of echocardiography in the assessment of intra-cardiac masses because it provided sufficient information about size and attachment. According to these characteristic findings, we diagnosed the mass blood-filled cyst of tricuspid valve.
| D ISCUSS I ONCardiac blood cysts are common congenital malformations in infancy, but this is rare in adulthood. Most blood cysts are found on the left side of the heart and on atrioventricular valves. 1,2 Rarely, they originate from the right atrium and ventricle. 3,4 There is still uncertainty about the pathophysiology and embryonic development of such cysts. Several hypotheses have been proposed about the development of these cysts. A hypothesis then involves the formation
AbstractCardiac blood cysts are confirmed by autopsies in stillbirths but rarely detected in adults. Although cardiac blood cysts are common in newborns, they disappear within a few months after birth. These cysts are blood-filled diverticula surrounded by endothelium. Their possible etiology is invaginations of atrial endothelium into the stroma of atrioventricular valves. Most blood cysts originate from the left side of the heart and are located on the atrioventricular valves. Complication is followed in very little cases, such as embolic stroke, valvular dysfunction, and ventricular outflow system obstruction. The blood cysts leading to complications should be removed surgically.