Multimodality cardiac imaging for management of a cardiac mass in the era of COVID-19: a case report.

European Heart Journal. Case Reports
Pragya RanjanLori Croft

Abstract

Atrial myxomas are the most common benign cardiac tumours. This case highlights an unusual presentation and complex management of a patient who was incidentally found to have a left atrial tumour concerning for a myxoma. A 54-year-old-woman presented with symptoms of nausea and vomiting and was found to have a left atrial mass incidentally in addition to a renal infarct. She was also found to have COVID-19 and the mass was initially thought to be a thrombus. With the help of multimodality imaging, it was determined that the mass was an atrial myxoma and she was started on short-term anticoagulation to prevent recurrent embolization. After 6 weeks of anticoagulation, she successfully underwent elective resection of the mass which was confirmed to be myxoma with superimposed thrombus. It is difficult to differentiate cardiac tumours from intracardiac thrombus and multimodality cardiac imaging is crucial to make an accurate diagnosis. While the treatment of atrial myxomas involves early surgical resection, it becomes more complicated with concurrent COVID-19 infection.

References

May 1, 1979·Current Problems in Cardiology·H A McAllister
Jan 1, 1996·The American Journal of Cardiology·K Reynen
Feb 12, 2017·JACC. Cardiovascular Imaging·Abdallah El SabbaghVuyisile T Nkomo
Apr 21, 2020·Journal of the American College of Cardiology·Behnood BikdeliUNKNOWN Global COVID-19 Thrombosis Collaborative Group, Endorsed by the ISTH, NATF, ESVM, and the IUA, Supported by the ESC Working
Apr 29, 2020·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Yuchi HanJames Carr

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