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Updated: Jul 20, 2026

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Fatty lesions of the atria and interatrial septum
Kristopher S Cunningham1, John P Veinot, Christopher M Feindel
1Department of Pathology, University Health Network, University of Toronto, Toronto, Ontario, Canada M5G 2C4.
Insights
Cardiac lipomatous lesions in the atria are uncommon but can cause serious issues like arrhythmias. Accurate diagnosis is key to avoid unnecessary surgeries for these fatty heart masses.
Area of Science:
- Cardiology
- Cardiac Pathology
- Medical Imaging
Background:
- Lipomatous lesions of the heart, particularly in the atria and interatrial septum, are not widely recognized.
- While often asymptomatic, extensive fatty infiltration or tumors can lead to significant clinical problems.
Purpose of the Study:
- To describe the pathology of common cardiac lipomatous lesions.
- To highlight diagnostic and management challenges, including radiographic and surgical considerations.
Main Methods:
- Review of pathological findings in cardiac lipomatous lesions.
- Analysis of radiographic characteristics and clinical presentations.
- Discussion of surgical implications and potential misdiagnoses.
Main Results:
- Lipomatous lesions can cause intractable arrhythmias, blood flow obstruction, and valvular disruption.
- Radiological characterization can be challenging, potentially leading to misdiagnosis.
- Benign or malignant lipomatous tumors may present as significant cardiac masses.
Conclusions:
- Understanding the pathology of atrial lipomatous lesions is crucial for accurate diagnosis.
- Careful radiological assessment and clinical correlation are necessary to guide management.
- Avoiding unnecessary surgical interventions relies on precise characterization of these fatty cardiac masses.
Abstract:
Lipomatous lesions of the heart involving the atria and interatrial septum are not well known. Most such lesions do not become clinically significant; however, intractable arrhythmias, blood flow obstruction, and valvular disruption may result from extensive fatty infiltration of the atrial wall or from the mass effect of benign or malignant lipomatous tumors. Some fatty lesions may be difficult to characterize radiologically, and misdiagnosis may lead to unnecessary surgical interventions. We describe the pathology of the most common fatty lesions and underscore some of the radiographic and surgical issues pertaining to the diagnosis and management of these masses.
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