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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
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Right atrial tuberculoma enclosed by thrombus
Freidoun Sabzi1, Reza Faraji2, Saeed Khoshnood3
1Department of General Surgery, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Global Cardiology Science & Practice
|October 1, 2024
Summary
Right atrial tuberculoma, a rare heart mass in HIV patients, was diagnosed in a 24-year-old man presenting with a thrombus. Surgical removal and TB therapy were effective, with no recurrence at follow-up.
Area of Science:
- Cardiology
- Infectious Diseases
- Oncology
Background:
- Right atrial tuberculoma (RAT) is a rare cardiac mass, often linked to primary pulmonary tuberculosis (TB) in human immunodeficiency virus (HIV) infected individuals.
- HIV infection creates a pro-thrombotic state and endothelial damage, increasing the risk of both tuberculoma and thrombus formation in the right atrium.
Observation:
- A 24-year-old HIV-positive male presented with dyspnea and pleural effusion, initially suspected as a right atrial thrombus.
- Transthoracic echocardiography (TEE) detected the mass, but histological examination confirmed it as a tuberculoma.
Findings:
- Histological examination confirmed the right atrial mass as a tuberculoma in an HIV-positive patient with a suspected thrombus.
- The patient underwent successful surgical resection of the mass and received combined TB and HIV therapy.
Implications:
- This case highlights the importance of considering tuberculoma in the differential diagnosis of cardiac masses, especially in HIV patients.
- Early diagnosis and appropriate treatment, including surgery and prolonged antimicrobial therapy, are crucial for managing right atrial tuberculoma and preventing recurrence.
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