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[Left ventricular hypertrophy simulating an intracavitary tumor. Echocardiographic diagnosis]
L S Acevedo Jaramillo1, J Vargas-Barrón, A Santana González
1Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
Insights
A severe pulmonary valve stenosis in an infant mimicked a right ventricular tumor. Echocardiography differentiated the tumor-like mass as right ventricular hypertrophy, crucial for diagnosis.
Area of Science:
- Pediatric Cardiology
- Diagnostic Imaging
- Cardiovascular Pathology
Background:
- Severe pulmonary valve stenosis can present with complex intracardiac findings.
- Distinguishing intracardiac masses from hypertrophic changes is critical for appropriate management.
- Infants with heart failure require prompt and accurate etiological diagnosis.
Observation:
- A 14-month-old infant presented with heart failure symptoms.
- Angiography suggested a right ventricular tumor mass.
- Right heart catheterization revealed a pulmonary gradient and infundibular filling defects.
Findings:
- Two-dimensional and Doppler echocardiography identified the 'mass' as anterior right ventricular wall hypertrophy.
- Pulmonary stenosis was confirmed as the underlying cause.
- Echocardiography proved effective in differentiating RV tumor from hypertrophy.
Implications:
- Echocardiography is the primary diagnostic tool for differentiating right ventricular masses from hypertrophy in pulmonary stenosis.
- Accurate diagnosis prevents unnecessary interventions for misidentified intracardiac masses.
- Understanding this differential diagnosis is vital for pediatric cardiac care and treatment planning.
Abstract:
We report a case of a 14 month old infant with severe stenosis of the pulmonary valve in whom the angiographic image suggested the presence of a right ventricular (RV) tumor mass. The patient was admitted because of clinical manifestations of heart failure. Right heart catheterization demonstrated a transvalvular pulmonary gradient and filling defects in the infundibulum compatible with an intracavitary mass. Two dimensional and Doppler echocardiography confirmed pulmonary stenosis and showed that the mass corresponded to hypertrophy of the anterior RV wall. The combination of two dimensional and Doppler echocardiography are the indicated techniques in differential diagnosis of RV tumor masses and RV hypertrophy secondary to severe pulmonary valve stenosis.