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Published on: July 5, 2021
[A case of left atria subendocardial thrombus with sick sinus syndrome]
1Department of Cardiovascular Surgery, Second Xiangya Hospital, Central South University, Changsha 410011; Department of Ultrasound, Affiliated Haikou Hospital, Xiangya School of Medicine, Central South University, Haikou 570208, China.
Insights
This case study highlights a patient misdiagnosed with a left atrial tumor who actually had infective endocarditis and a left atrial thrombus. Accurate diagnosis requires integrating imaging and clinical data to differentiate masses.
Area of Science:
- Cardiology
- Pathology
Background:
- Sick sinus syndrome management often involves addressing symptoms like palpitations and chest pain.
- Echocardiography is a key initial imaging modality for cardiac assessments.
Observation:
- A patient presenting with palpitations and chest pain was initially evaluated for a left atrial tumor based on echocardiography.
- Further investigations including CT scan and dynamic ECG were performed.
Findings:
- Surgical resection revealed infective endocarditis and a left atrial thrombus, not a tumor.
- Postoperative pathology confirmed successful treatment of the infective endocarditis and thrombus.
Implications:
- This case underscores the importance of combining advanced imaging with thorough clinical evaluation to accurately diagnose cardiac masses.
- Distinguishing between tumors and thrombi, especially in cases of infective endocarditis, is critical for appropriate patient management and surgical planning.
Abstract:
The clinical data for a patient with sick sinus syndrome was retrospectively analyzed. The patient was treated because of his heart palpitations and the increased chest pain. The patient admitted to the hospital under consideration for the left atrial tumor dependent on the echocardiography findings. After the CT scan and the dynamic ECG examination, the patient successfully underwent the left atrial tumor resection, atrial septal repair and cardiac pacing lead installation. The postoperative pathological diagnosis showed that the infective endocarditis and left atrial thrombus in left atrium was cured. The patient was discharged after postoperative anti-inflammatory therapy. By analyzing the reasons for misdignosis before or during surgery, the possible mechanisms for left atrial subendocardial thrombus have been found. This study suggests that it is necessary to combine imaging diagnosis and clinical observations to distinguish tumor from excrescence.
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