Failure of Echocardiography to Detect a Large Left Atrial Myxoma Khaled E. Al-Ebrahim, FRCSC Department of Cardiac Surgery, King Abdulaziz University, Jeddah, Saudi Arabia A 65-year-old man presented with left-sided hemi- plegia. The result of transthoracic echocardiography (TTE) (Fig 1) was normal. Magnetic resonance imaging (MRI) (Fig 2) was done to search for a source of emboli. It showed posterior left atrial myxoma of 1.2 1.5 cm. The mass was excised, and the diagnosis was conﬁrmed histologically. Computed tomography (CT) and MRI allow differentiation of different tissue types and may guide the surgeon as to the likely gross morphology of the tumor. MRI provides speciﬁc information about tissue characteristics that facilitate differentiating between myxoma and thrombi. Transthoracic two- dimensional echocardiography must be supplemented by transesophageal, three-dimensional echocardiography, CT, or MRI before myxoma can be ruled out. Two- dimensional TTE is not the diagnostic modality of choice in cases of cardiac myxoma. The valuable admonition contained in this contribution is that TTE is not adequate to exclude an atrial myxoma and that when clinical suspicion exists, other diagnostic modes must be used. Fig 1. Fig 2. Address correspondence to Dr Al-Ebrahim, Department of Surgery, King Abdulaziz University Hospital, PO Box 80215, Jeddah 21589, Saudi Arabia; e-mail: [email protected]. Ó 2013 by The Society of Thoracic Surgeons Ann Thorac Surg 2013;96:1881 0003-4975/$36.00 Published by Elsevier Inc http://dx.doi.org/10.1016/j.athoracsur.2013.02.060 FEATURE ARTICLES

Failure of Echocardiography to Detect a Large Left Atrial Myxoma

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Page 1: Failure of Echocardiography to Detect a Large Left Atrial Myxoma

Failure of Echocardiography to Detect a Large LeftAtrial MyxomaKhaled E. Al-Ebrahim, FRCSCDepartment of Cardiac Surgery, King Abdulaziz University, Jeddah, Saudi Arabia

CLES

65-year-old man presented with left-sided hemi-

Fig 1.

Fig 2.

FEATUREARTI

Aplegia. The result of transthoracic echocardiography

(TTE) (Fig 1) was normal. Magnetic resonance imaging(MRI) (Fig 2) was done to search for a source of emboli. Itshowed posterior left atrial myxoma of 1.2 � 1.5 cm. Themass was excised, and the diagnosis was confirmedhistologically. Computed tomography (CT) and MRIallow differentiation of different tissue types and mayguide the surgeon as to the likely gross morphology ofthe tumor. MRI provides specific information abouttissue characteristics that facilitate differentiatingbetween myxoma and thrombi. Transthoracic two-dimensional echocardiography must be supplementedby transesophageal, three-dimensional echocardiography,CT, or MRI before myxoma can be ruled out. Two-dimensional TTE is not the diagnostic modality of choicein cases of cardiac myxoma. The valuable admonitioncontained in this contribution is that TTE is not adequate toexclude an atrial myxoma and that when clinical suspicionexists, other diagnostic modes must be used.

Address correspondence to Dr Al-Ebrahim, Department of Surgery, KingAbdulaziz University Hospital, PO Box 80215, Jeddah 21589, Saudi Arabia;e-mail: [email protected].

� 2013 by The Society of Thoracic Surgeons Ann Thorac Surg 2013;96:1881 � 0003-4975/$36.00Published by Elsevier Inc http://dx.doi.org/10.1016/j.athoracsur.2013.02.060

mailto:[email protected]

http://dx.doi.org/10.1016/j.athoracsur.2013.02.060