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Left atrial thrombus masquerading as a myxoma in a patient with mitral stenosis

Sobhan Kodali1, June Yamrozik, Robert W W Biederman

  • 1Division of Cardiology, Gerald McGinnis Cardiovascular Institute, Allegheny General Hospital, Drexel University College of Medicine, Pittsburgh, Pennsylvania, USA. shoban.kodali@gmail.com

Echocardiography (Mount Kisco, N.Y.)
|November 3, 2010
PubMed

Insights

Differentiating left atrial appendage thrombi from myxomas preoperatively can be challenging. This case demonstrates how an organized thrombus can mimic a myxoma on cardiac MRI, leading to misdiagnosis.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging

Background:

  • Preoperative differentiation between left atrial appendage thrombus and myxoma is clinically significant but often difficult.
  • Standard clinical and echocardiographic features may not reliably distinguish these conditions.

Observation:

  • A patient presented with a left atrial appendage thrombus.
  • The thrombus was misdiagnosed as a myxoma based on cardiac magnetic resonance imaging characteristics.
  • Coronary angiography revealed dense neovascularization, which contributed to the misdiagnosis.

Findings:

  • The organized thrombus exhibited imaging features mimicking a myxoma.
  • Neovascularization on coronary angiography further supported the misdiagnosis of myxoma.

Implications:

  • This case underscores the potential for organized thrombi to present with atypical features that resemble myxomas.
  • Enhanced awareness and advanced imaging interpretation are crucial for accurate preoperative diagnosis.
  • Improved diagnostic strategies are needed to avoid misclassification and ensure appropriate patient management.

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