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Prominent crista terminalis mimicking a right atrial mass: case report

Alessandro Salustri1, Sherif Bakir, Amer Sana

  • 1Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates. asalustri@skmc.gov.ae

Cardiovascular Ultrasound
|October 21, 2010
PubMed

Insights

A prominent crista terminalis can mimic a right atrial mass on echocardiograms. Recognizing this normal anatomical structure prevents misdiagnosis and unnecessary tests in patients with end-stage renal disease.

Area of Science:

  • Cardiovascular Imaging
  • Cardiac Anatomy

Background:

  • The crista terminalis is a normal muscular band in the right atrium.
  • Standard transthoracic echocardiography (TTE) often fails to visualize the crista terminalis.
  • Misidentification can lead to misdiagnosis of cardiac masses.

Observation:

  • A patient with end-stage renal disease presented with a suspected right atrial mass on TTE.
  • Further investigation using transesophageal echocardiography (TEE) was performed.
  • TEE revealed a prominent crista terminalis, appearing as a muscular bridge, not a true mass.

Findings:

  • The suspected right atrial mass was identified as a prominent crista terminalis.
  • This finding highlights the importance of detailed echocardiographic views.
  • Accurate identification relies on understanding cardiac anatomy and imaging characteristics.

Implications:

  • Understanding the echocardiographic appearance of the crista terminalis is crucial for accurate cardiac diagnosis.
  • Misdiagnosis of the crista terminalis can lead to unnecessary and costly investigations.
  • Improved TEE interpretation can enhance diagnostic accuracy and patient management.

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