Related Experiment Video
Updated: Sep 19, 2025
06:29
Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
10.5K
The great masquerade: TB endomyocarditis as left ventricular mass
Ikshudhanva Tharranath1,2, Channabasavaraj Shivalingayya Hiremath1,3, Sudheer Arava4
1Department of Cardiothoracic Vascular Surgery, SSIHMS Whitefield Bengaluru, Bengaluru, India.
Indian Journal of Thoracic and Cardiovascular Surgery
|June 19, 2025
Summary
Tuberculosis endomyocarditis can present as a rare cardiac mass. Prompt diagnosis and anti-tubercular treatment led to significant reduction of a left ventricular mass.
Area of Science:
- Cardiology
- Infectious Diseases
- Oncology
Background:
- Cardiac masses are uncommon and challenging to diagnose due to sampling difficulties.
- Imaging modalities are crucial for initial diagnosis of cardiac abnormalities.
Observation:
- A 25-year-old male presented with constitutional symptoms and a large left ventricular mass with high standardized uptake value (SUV), mimicking malignancy.
- Initial chemotherapy for suspected sarcoma or lymphoma was ineffective.
Findings:
- Biopsy revealed necrotizing abscesses and granulomas, ruling out malignancy.
- A positive tuberculin test and subsequent anti-tubercular treatment (HRZE) led to a >90% reduction in mass size on MRI.
- This case represents a rare instance of primary intracardiac tuberculosis endomyocarditis.
Implications:
- Highlights the importance of considering tuberculosis in the differential diagnosis of atypical cardiac masses, even without typical exposure history.
- Emphasizes the effectiveness of anti-tubercular therapy in managing cardiac tuberculosis presenting as a mass.
- Underscores the value of multidisciplinary evaluation in complex cardiac cases.
Related Concept Videos
01:22Mitral Stenosis I: Introduction
50
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
50
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
39
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
39
01:27Myocarditis II: Clinical Features and Diagnostic Tests
32
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
32
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
65
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
65
01:25Endocarditis II: Clinical Features of Infective Endocarditis
29
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
29
01:30Cardiomyopathy II: Dilated Cardiomyopathy
30
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
30