A Left Atrial Mass in the Time of COVID

Abstract

A 60-year-old woman presented to the emergency department with chest pain and worsening dyspnea. On initial vital signs, she was afebrile with a blood pressure of 160/107 mmHg, a heart rate of 89 beats/min, a respiratory rate of 30 breaths/min, and an oxygen saturation of 95% on 4 liters oxygen via nasal cannula (an increase from her home requirement of 2 liters oxygen via nasal cannula). Her weight on presentation was 10.9 kg above her baseline. Her exam was notable for elevated jugular venous pressure to 14 cm of water, rales in bilateral lung bases without wheezes, and significant bilateral lower extremity edema to her thighs.