Right Atrial Lipoma Presenting with Angina

Abstract

Case A 54-year-old woman visited the emergency department due to chest pain for 3 hours associated with diaphoresis. She had suffered from symptoms of angina, which were triggered sometimes, not always, by positional change like standing from squatting, rotating the chest, walking or jogging. Her electrocardiogram was normal. Her cardiac enzymes were within normal ranges. Exercise electrocardiogram revealed no abnormal finding. Transthoracic echocardiography demonstrated a mass (about 3×4.5 cm diameter) arising from the free wall of right atrium, and sparing tricuspid valve (Fig. 1A). We believed it was a wellcapsulated primary cardiac tumor, such as a myxoma or lipoma. Chest computed tomographic scan showed a wellcapsulated cardiac tumor that had same density with subcutaneous fat, suggesting lipoma rather than myxoma