Abstract
An 88-year-old man presented to the emergency department for palpitations with a recent episode of syncope. His blood sugar was normal. He had a blood pressure of 125/88 mm Hg but had an irregular heart rhythm and a pulse rate of 149 beats/min. ECG showed atrial fibrillation. Point-of-care ultrasonography showed an indeterminate lesion near the left atrium on subcostal four-chamber view (Figure 1A, and Video E1 [available online at http://www.annemergmed.com]), and a hypoechoic lesion between the left atrium and the descending aorta on parasternal long-axis view of the heart (Figure 1B, and Video E2).
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