Diagnostic dilemma: Intracardiac mass in a woman with Behçet's syndrome

Area of Science:

• Cardiology
• Rheumatology
• Vascular Medicine

Background:

• Behçet's disease is a multisystemic inflammatory disorder.
• Cardiac involvement in Behçet's disease is uncommon.
• Intracardiac masses can be challenging to diagnose, potentially mimicking neoplasms.

Observation:

• A patient with Behçet's disease presented with an incidental right atrial mass.
• Initial imaging suggested a cardiac tumor.
• Cardiac magnetic resonance imaging (MRI) revealed the mass to be a thrombus.

Findings:

• The right atrial mass was diagnosed as intracardiac thrombosis, a rare cardiac manifestation of Behçet's disease.
• The patient's condition was successfully managed with a combination of immunosuppressive therapy and anticoagulation.
• Complete resolution of the cardiac thrombus was achieved.

Implications:

• This case highlights the importance of considering intracardiac thrombosis in Behçet's disease patients with cardiac masses.
• Accurate diagnosis via advanced imaging like cardiac MRI is crucial to differentiate thrombus from tumor.
• Effective management involves addressing both the underlying systemic inflammation and the thrombotic event.