An 82-year-old woman with a cardiac mass. Issue 11 (7th January 2016)

• Record Type: Journal Article
• Authors: Galas, Anna; Hryniewiecki, Tomasz; Szymanski, Piotr
• Is Part Of: Heart. Volume 102:Issue 11(2016)
• Page Start: 881
• Page End: 881
• Publication Date: 2016-01-07
• Subjects: Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2015-308617
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Clinical introduction: An 82-year-old woman suspected of a cardiac tumour was referred for evaluation. Patient's medical history included atrial fibrillation, implantation of a VVI (ventricular stimulation) pacemaker 3 years earlier due to advanced atrioventicular (AV) block, arterial hypertension and hypothyroidism. Patient was adequately anticoagulated with warfarin (international normalized ratio (INR) 3.0 at admission). She reported occasional palpitations and a 2 kg weight loss in the last 2 years, but denied shortness of breath, chest pain, malaise, fever, chills or cough. Blood samples were taken for tests and cultures. Red blood cells, haemoglobin, white blood cells, platelets, C- reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were within normal ranges. Blood cultures were negative. Echocardiogram (figure 1A) (see online supplementary videos 1 and 2) and cardiac CT were performed (figure 1B). Question: Which of the following is the most likely diagnosis? Caseous calcification of the mitral annulus Coconut left atrium Mitral valve myxoma Periannular abscess