Left Atrial Compression by a Pericardial Hematoma Presenting as an Obstructing Intracavitary Mass: A Difficult Differential Diagnosis

Abstract

The differential diagnosis of extracavitary, intramural and intracavitary disease may be difficult. An extrinsic compression of the left atrium by a dissecting pericardial hematoma was misdiagnosed as an intracavitary mass, by echocadiography and computer tomography. This case emphasizes the importance of patient history and clinical setting.

Biatrial compression caused by intrapericardial hematoma secondary to ruptured type I acute aortic dissection following aortic valve replacement

“…Single-chamber compression by a dissecting pericardial hematoma can involve any cardiac chamber, but the right atrium is most frequently affected [5]. In the case presented, however, both atria were compressed.…”

Unusual Presentation of Postcardiotomy Hemorrhage in an Infant with Congenital Heart Disease

“…2). Ambiguity of echocardiography in the diagnosis of pericardial and intramural cardiac hematomas versus intracavitary masses has been reported in adults and an adolescent after cardiovascular surgery (1,2). The impression that the echodensity represented an intracardiac thrombus in this case led to inappropriate anticoagulation therapy, which may have contributed to hematoma expansion.…”

Atrioventricular Groove Hematoma During Mitral Valve/Tricuspid Valve Repair

“…Although TEE can be very helpful in diagnosing such rare complications, it is not always accurate, and false diagnoses have been reported. 2 Hence, a high degree of suspicion is recommended. The atrioventricular groove hematoma in our case was assessed on TEE using multiple views and was found to extend along the posterior left atrial wall in a medial to lateral direction.…”