Quick Fire Cases
Aamer Ubaid, MD
Cardiovascular Disease Fellow
Allegheny General Hospital
Aamer Ubaid, MD
Cardiovascular Disease Fellow
Allegheny General Hospital
Kyle Kapcin, DO
Resident / DO
Allegheny General Hospital
Manasvi Gupta, MD
Fellow / MD
Allegheny General Hospital
Daniel R. Davies, MD
Fellow, Assistant Professor
Mayo Clinic
Victor Farah, MD, FSCMR
Associate Program Director
Allegheny General Hospital
A 77-year-old female patient with unknown prior history presented with an acute episode of heart failure. A chest X-ray revealed a left atrial density, which appeared as a peripherally calcified filling defect on CT angiography concerning for a dislodged interatrial closure device. Echocardiography confirmed a pedunculated mass originating from the interatrial septum. Incidentally, a pelvic mass was discovered, suggesting endometrial malignancy with peritoneal metastases.
Diagnostic Techniques and Their Most Important Findings:
Given lack of known procedural history, a cardiac MRI was performed to characterize the mass. This showed a mobile, well-circumscribed mass in the left atrium concerning for a myxoma. In the setting of her endometrial cancer, however, a metastasis could not be discounted. An FDG PET revealed that the calcified mass had no FDG uptake, supporting the diagnosis of a myxoma rather than a metastasis.
Learning Points from this Case:
Multimodality cardiac imaging provides unmatched value due to the unique strengths of different imaging types. While not histologically diagnostic, cardiac MRI plays an important role in the characterization of cardiac masses.
