Left ventricular mass: A tumor or a thrombus diagnostic dilemma

Kumar, U S Dinesh; Shetty, Shyam Prasad; Sujay, K R; Wali, Murugesh

doi:10.4103/0971-9784.191551

Cited by 15 publications

(9 citation statements)

References 8 publications

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“…In terms of treatment, organized and small thrombus can be treated medically with anticoagulants, thrombolysis or thrombectomy [10]. Anticoagulation with high dose intravenous heparin or low molecular weight heparin has variable resolution rates 13-59%.…”

Section: Treatmentmentioning

confidence: 99%

“…Recombinant tissue plasminogen activator can be used for lysis of a mobile, pedunculated LV thrombus [11]. On the other hand, a large mobile thrombus with or without a hemodynamic alteration, prior embolic events, and failed anticoagulation are an indication for surgical removal [10]. Furthermore, in the Ogren 2005 European study [12], right atrial (RA) thrombus was described in about 10% of patients with PE, and of patients with RA thrombus, 36% had PE and 6.5% of patients with PE confirmed at autopsy had RA thrombus [13].…”

Section: Treatmentmentioning

confidence: 99%

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Case report: left atrial Myxoma causing elevated C-reactive protein, fatigue and fever, with literature review

Cho

Quach

Reed

et al. 2020

BMC Cardiovasc Disord

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Background: A cardiac myxoma in a young person may pose a diagnostic challenge as symptoms may be variable and the differential diagnosis is wide. The differential diagnosis can include rheumatic mitral valve disease, pulmonary hypertension, endocarditis, myocarditis and vasculitis. Case presentation: This case report involves a 49 years old female with a 2.8 cm × 3.4 cm myxoma in the left atrium causing mitral valve obstruction. She presented with fatigue, fever of unknown origin, transient ischemic attack and shortness of breath. Prompt surgery is often recommended due to the risk of embolic complications or complete obstruction. Due to her symptoms, patient underwent successful cardiothoracic surgery to excise the myxoma within 2 weeks of confirmation by cardiac echocardiography. Conclusion: This case also emphasizes the diagnostic challenge as symptoms may be variable, ranging from fatigue, fever and shortness of breath to transient ischemic attack and at worst, sudden cardiac death. In conclusion, if a cardiac mass is suspected, echocardiography should be performed early. Surgical resection is curative and recurrence rate is very rare in sporadic isolated myxomas, however, recurrence can be higher in genetic diseases associated with increased frequency of myxomas such as Carney complex. This subpopulation of patients may present further research opportunity to learn more about the perioperative management of patients with myxomas such as determining the optimal time to surgical intervention and decision to anticoagulate.

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Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Case report: left atrial Myxoma causing elevated C-reactive protein, fatigue and fever, with literature review

Cho

Quach

Reed

et al. 2020

BMC Cardiovasc Disord

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“…Thrombi are the most common intra-cardiac mass, occurring in up to 7% of hospitalized patients requiring transthoracic echocardiography (TTE) [ 1 ]. These thrombi are usually associated with atherosclerotic cardiovascular disease, cardiomyopathies, and hypercoagulable states [ 2 ]. On echocardiography thrombi have increased echogenicity compared to local tissue and well-delineated borders with or without adhesion to the endocardium.…”

Section: Introductionmentioning

confidence: 99%

“…Cardiac tumors are significantly less common with an estimated prevalence of 0.3% of patients undergoing autopsy [ 2 ]. Tumors may be subdivided into primary cancer and secondary (metastatic) cancer, which is 20–40 times more common [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Left ventricular mass in a patient with severe heart failure

Wangmang

Joseph

2020

African Journal of Emergency Medicine

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Introduction Cardiac masses have a wide range of etiologies with the most common being thrombi and less commonly tumors. However, in Sub-Saharan Africa other etiologies not commonly seen in developed countries such as endomyocardial fibrosis (EMF) must be considered. EMF is a disease process associated with poverty, a poor diet, and eosinophilia although its pathology is poorly understood. Case report We report a case of a 53-year-old male with a history of dilated cardiomyopathy who presented to a Ugandan Emergency Department in respiratory distress. Bedside echocardiography was performed which revealed a large mass in the apex of the left ventricle. The patient was subsequently given supplemental oxygen and intravenous furosemide, however he later died while in the emergency department due to limited resources and lack of definitive care. Discussion The list of potential etiologies of cardiac masses is widely variable, and in settings such as Sub-Saharan Africa, this list must be expanded to include possible diagnoses such as EMF. EMF is a diagnosis that should be considered in patients presenting with respiratory distress and a cardiac mass present on echocardiography, such as the case presented here. The limited opportunities for medical personnel to diagnose cardiovascular disease can be made more efficient by the use of diagnostic imaging devices which are portable, yet capable of diagnosing the most common local pathologies [9-11].

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“…We read with great interest the article – Left ventricular mass: A tumor or a thrombus diagnostic dilemma, describing the narrated differential diagnosis. [ 1 ] Left ventricular thrombus formation is commonly observed in patients with myocardial infarction with systolic dysfunction. However, it becomes difficult to come to the certain diagnosis when such situation occurs in patients with absent history of coronary artery disease and normal ventricular function.…”

mentioning

confidence: 99%