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The Clot Thickens: Unusual Presentation of a Left Atrial Thrombus
Stephen F. Lau1, James S. Hood2, Dorinna D. Mendoza3, Carolyn Yi Li4, Maria Ansari5, Jamal S. Rana3, 6
1 Department of Internal Medicine, Kaiser Permanente Oakland Medical Center, Oakland, CA
2 Department of Cardiothoracic Surgery, Kaiser Permanente San Francisco Medical Center, San Francisco, CA
3 Department of Cardiology, Kaiser Permanente Oakland Medical Center, Oakland, CA
4 Department of Pathology, Kaiser Permanente San Francisco Medical Center, San Francisco, CA
5 Department of Cardiology, Kaiser Permanente San Francisco Medical Center, San Francisco, CA
6 Department of Medicine, University of California, San Francisco, San Francisco, CA
Rev. Cardiovasc. Med. 2015, 16(1), 81–83; https://doi.org/10.3909/ricm0745
Published: 30 March 2015
Left atrial thrombi are a significant cause of cardioembolic morbidity and mortality. Transesophageal echocardiography is the preferred method for complete visualization of atrial thrombi, and has a sensitivity and specificity of up to 100% and 99%, respectively. Cardiac magnetic resonance imaging has been shown to be useful in identifying tissue characteristics that may aid in differentiating between atrial myxoma and thrombi. This is an unusual case of a large, free-floating atrial thrombus with a cystic appearance that was surgically removed. The echocardiographic appearance of the cystic atrial mass led to the consideration of another potential etiology for a cardiac mass, namely, atrial myxoma. Histopathologic analyses of the mass led to the final diagnosis of an atrial thrombus.
Cardiac magnetic resonance imaging