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Gepubliceerd in: Netherlands Heart Journal 10/2021

Open Access 02-06-2021 | Heart Beat

Substance of ‘phantom’ cardiac masses confirmed by therapeutic outcome

Auteurs: D. Afendoulis, N. Papagiannis, M. Moutafi, G. Panagi, P. Voutas, S. Garoufalis, N. Smyrnioudis, A. Kartalis

Gepubliceerd in: Netherlands Heart Journal | Uitgave 10/2021

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Urgent transthoracic and transesophageal echocardiogram depicting enormous, mobile masses in the cardiac chambers
Opmerkingen

Video online

The online version of this article contains one video. The article and the video are online available (https://​doi.​org/​10.​1007/​s12471-021-01587-2). The video can be found in the article back matter as “Electronic Supplementary Material”.
An 87-year-old woman presented to the emergency department of our hospital with acute-onset chest pain and a presyncopal episode. She was haemodynamically stable with sinus tachycardia and 93% oxygen saturation. Urgent transthoracic echocardiography and transoesophageal echocardiography (Fig. 1; Movie 1, Electronic Supplementary Material) demonstrated enormous, highly mobile masses in both atria, protruding into both ventricles, an intact interatrial septum, mild systolic right ventricular dysfunction and pulmonary hypertension. CT pulmonary angiography (CTPA) displayed the atrial masses and bilateral pulmonary embolism at the main pulmonary artery branches (Fig. 2a, b). Considering that our patient was at high risk of bleeding from thrombolysis [13] and the substance of the masses was unknown, low-molecular-weight heparin was initiated. Duplex ultrasonography of the lower extremities and total-body computed tomography displayed no signs of deep vein thrombosis or active malignancy. One week later she was discharged in a stable condition on direct oral anticoagulants. Follow-up echocardiography and CTPA demonstrated complete resolution of the cardiac masses, confirming the diagnosis of ‘heart thrombi’.

Conflict of interest

D. Afendoulis, N. Papagiannis, M. Moutafi, G. Panagi, P. Voutas, S. Garoufalis, N. Smyrnioudis and A. Kartalis declare that they have no competing interests.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://​creativecommons.​org/​licenses/​by/​4.​0/​.
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Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

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Supplementary Information

Urgent transthoracic and transesophageal echocardiogram depicting enormous, mobile masses in the cardiac chambers
Literatuur
1.
go back to reference Kearon C, Akl EA, Ornelas J, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest. 2016;149:315–52.CrossRef Kearon C, Akl EA, Ornelas J, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest. 2016;149:315–52.CrossRef
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go back to reference Meyer G, Vicaut E, Danays T, et al. Fibrinolysis for patients with intermediate-risk pulmonary embolism. N Engl J Med. 2014;370:1402–11.CrossRef Meyer G, Vicaut E, Danays T, et al. Fibrinolysis for patients with intermediate-risk pulmonary embolism. N Engl J Med. 2014;370:1402–11.CrossRef
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go back to reference Konstantinides SV, Vicaut E, Danays T, et al. Impact of thrombolytic therapy on the long-term outcome of intermediate-risk pulmonary embolism. J Am Coll Cardiol. 2017;69:1536–44.CrossRef Konstantinides SV, Vicaut E, Danays T, et al. Impact of thrombolytic therapy on the long-term outcome of intermediate-risk pulmonary embolism. J Am Coll Cardiol. 2017;69:1536–44.CrossRef
Metagegevens
Titel
Substance of ‘phantom’ cardiac masses confirmed by therapeutic outcome
Auteurs
D. Afendoulis
N. Papagiannis
M. Moutafi
G. Panagi
P. Voutas
S. Garoufalis
N. Smyrnioudis
A. Kartalis
Publicatiedatum
02-06-2021
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Netherlands Heart Journal / Uitgave 10/2021
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-021-01587-2

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