Abstract
A 56-year-old man presented with superior vena cava syndrome after recovery from severe COVID-19. Chest X-rays showed multiple bilateral pulmonary nodules (Panel A). A transthoracic echocardiogram revealed a mass in the right atrium of 54 × 31 mm, that protruded through the tricuspid valve and generated an obstructive gradient of 15 mmHg (Panel B; Supplementary Video 1). Contrast-enhanced chest computed tomography (CT) showed multiple pulmonary nodules (Panel C), and an intravascular extension of the intracardiac mass, deep into the innominate veins (Panels D and E). Volume 3D rendering CT showed extensive collateral venous circulation (Panel F). Steady-state free precession cine magnetic resonance imaging sequence showed an isointense mass with hyperintense areas in the right atrium, that measured 6.8 × 6.3 × 3.8 cm and prolapsed through the tricuspid valve (Panel G; Supplementary Video 2). The intracardiac mass was T1- and T2-weighted hyperintense (Panels H and I). Additionally, a mediastinum mass of 25 × 26 mm was found, with similar characteristics than the intracardiac mass.
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