Case 315

A 58-year-old man presented to the cardiology clinic with intermittent chest pain and a 5-day history of palpitations that were not associated with exercise. His medical history revealed that a cardiac mass was detected at echocardiography performed 3 years ago and for similar symptoms. However, he was lost to follow-up before his examinations were concluded. Apart from that, his medical history was unremarkable, and he had not experienced any cardiac symptoms in the intervening 3 years. He had a family history of sudden cardiac death, and his father died of a heart attack when he was 57 years old. Physical examination findings were unremarkable except for increased blood pressure (150/105 mmHg). Laboratory findings, including a complete blood count and creatinine, C-reactive protein, electrolyte, serum calcium, and troponin T levels, were within normal limits. Electrocardiography (ECG) was performed and revealed sinus rhythm and ST depression in the left precordial leads. Transthoracic two-dimensional echocardiography revealed an irregular left ventricle mass. The patient subsequently underwent contrast-enhanced ECG-gated cardiac CT followed by cardiac MRI to evaluate the left ventricle mass (Figs 1-5).