Noninvasive Characterization of Left Atrial Mass

Abstract

A 75-year-old woman presented for workup of a systolic murmur and recurring episodes of atrial fibrillation. Transthoracic and transesophageal echocardiography revealed biatrial dilatation, severe mitral valve stenosis, and a large left atrial mass attached to the atrial septum (IAS) (Figure 1). Thus, the patient was referred to us for presurgical cardiac catheterization. Coronary angiography ruled out coronary artery disease and demonstrated atypical vascularization of the left atrium, indicating additional perfusion and leaking of contrast media in the area where the mass was attached to the IAS (Figure 2). Movie I and Movie II show fully animated versions of Figure 1 and Figure 2, respectively. From the results of echocardiography and cardiac catheterization, the most likely diagnosis appeared to be left atrial myxoma. In patients with mitral valve stenosis, however, chronic atrial thrombus remains an important differential diagnosis. Therefore, the patient underwent cardiovascular MRI (CMR) for additional …