Big thrombus “sitting” in an atrial septal aneurysm

Abstract

A 79 year-old-man presented three episodes of upper gastrointestinal bleeding and weight loss. Endoscopy revealed bleeding and extrinsic compression at the pyloric region. Computed tomography scan showed a pancreatic tumor, peritoneal carcinomatosis, vascular infiltration, and incidentally found a partially calcified hypodense lesion of 35 mm in the left atrium, suggesting a myxoma or a thrombus. Echocardiography revealed moderate left atrium enlargement, dilated left atrial appendage with spontaneous echo contrast, moderate dilatation and dysfunction of the left ventricle, ejection fraction was 39%, and an atrial septal aneurysm in which a piriform, mass of 35×33×25 mm, was "sitting," suggesting an organized thrombus.

Left Atrial Thrombi Masquerading as Myxomas: Mini Case Series and Literature Review

“…Atrial thrombi masquerading as myxomas have been reported in the literature, with echocardiography and cardiac magnetic resonance being among the diagnostic modalities used. 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 We conducted a PubMed search for reports of left atrial thrombi misdiagnosed as myxomas and found 24 cases, 20 of which had predisposing procoagulant conditions, namely, atrial fibrillation in 11 patients, mitral stenosis in five patients, left ventricular dysfunction in three patients, and systemic lupus erythematosus in one patient. Details were not available for three patients, and one patient had undergone cardiac transplantation.…”

“…Details were not available for three patients, and one patient had undergone cardiac transplantation. 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45…”

Ischemic stroke on the background of probable in situ thrombosis of atrial septal aneurysm in a patient taking hormonal contraceptives

“…Из 15 подходящих под критерии публикаций были отобраны только клинические случаи АМПП без сопутствующих шунтов (открытого овального окна и/ или дефекта МПП) (табл.). Из 8 опубликованных клинических случаев лишь в трех у пациентов напрямую были визуализированы тромботические массы в АМПП [4][5][6], причем в двух из них у пациентов были верифицированы эмболические очаги в головном мозге [4,5], еще один случай [6] не подходил под вышеупомянутые критерии, потому что эмболических событий у пациента на момент обследования выявлено не было, а тромб в АМПП был ассоциирован с онкологическим заболеванием (опухоль поджелудочной железы).…”

Atrial septal aneurysm in Sub-Saharan Africa: From an asymptomatic incidental echocardiographic finding to a potential cause of cardio embolic stroke

“…There are different theories which try to explain increased thromboembolism in patients with ASA. 42 The ASA can be a direct source of thrombus formation. 42 There are reports documenting thrombotic material within the aneurysmal sac in patients at autopsy or cardiac surgery and micro thrombi attached to or generated within the cul de sac of the ASA.…”

“…42 The ASA can be a direct source of thrombus formation. 42 There are reports documenting thrombotic material within the aneurysmal sac in patients at autopsy or cardiac surgery and micro thrombi attached to or generated within the cul de sac of the ASA. 43 It has also been noted that there are marked thickening of the atrial septum suggestive of thrombus formation in patients with ASA.…”