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An interatrial mass supplied from dual coronary circulation
International Journal of Cardiology
|June 8, 2006
Summary
This case study highlights unusual cardiac masses causing obstruction, misdiagnosed as myxomas but revealed to have a different origin upon pathological examination.
Area of Science:
- Cardiology
- Pathology
- Medical Diagnostics
Background:
- A 69-year-old woman presented with presyncope and palpitations.
- Cardiac examination revealed a positional middiastolic rumbling murmur.
Observation:
- Echocardiography showed normal left ventricular function, mild mitral regurgitation, and large right and left atrial masses.
- These masses prolapsed through the mitral valve into the left ventricle during diastole, causing dynamic obstruction.
- Coronary angiography demonstrated vascular supply to the masses from both coronary arteries without significant stenosis.
Findings:
- Despite initial suspicion of multiple myxomas, pathological examination revealed a distinct, different origin for the cardiac masses.
- The masses caused significant hemodynamic compromise through dynamic outflow tract obstruction.
Implications:
- This case underscores the importance of comprehensive diagnostic evaluation, including pathology, for unusual cardiac masses.
- Accurate diagnosis is crucial for appropriate management and to differentiate from common cardiac tumors like myxomas.
- Highlights the potential for diverse etiologies of intracardiac masses presenting with obstructive symptoms.