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Pulmonary embolism with unexpected echocardiogram findings
Kencee K Graves1, Larry S Green, Robert C Pendleton
1University of Utah School of Medicine, Salt Lake City, UT 84132, USA. kencee.graves@hsc.utah.edu
Hospital Practice (1995)
|May 18, 2010
Summary
A pulmonary embolism diagnosis in a 56-year-old woman led to the discovery of an unexpected left atrial mass. This mass, initially suspected as a tumor, was confirmed as thrombus after embolization and treatment.
Area of Science:
- Cardiology
- Radiology
- Vascular Medicine
Background:
- Pulmonary embolism (PE) diagnosis and risk stratification.
- Role of echocardiography in assessing right ventricular function.
- Differential diagnosis of left atrial masses.
Observation:
- A 56-year-old woman presented with dyspnea, later diagnosed with pulmonary embolism.
- Echocardiography revealed right ventricular enlargement and a mobile left atrial mass.
- The left atrial mass was initially suspected to be an atrial myxoma.
Findings:
- Embolization to the left axillary artery occurred, prompting thrombolysis and embolectomy.
- Embolectomy confirmed the left atrial mass to be thrombus.
- Repeat echocardiography showed complete resolution of the mass and improved cardiac function.
Implications:
- Echocardiography is valuable for risk stratification in pulmonary embolism patients.
- Unexpected findings, such as thrombus mimicking a tumor, can occur.
- Clinical findings in PE should be evaluated holistically, considering Occam's razor for related etiologies.
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