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Rationale: Thrombus is the most common occupying lesion in the cardiac chambers, it is often distinguished from cardiac neoplastic occupations. Among them, the most common is cardiac myxoma, whose imaging manifestations are often confused with thrombus. However, the 2 types of lesions have different therapeutic strategies and are both potentially high-risk sources of embolism, so early differentiation between intracardiac thrombus and cardiac tumor is essential.

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Left Atrial Papillary Fibroelastoma Mimicking Myxoma.

JACC Case Rep

January 2025

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.

Papillary fibroelastomas (PFEs) followed by cardiac myxomas (CM) are the 2 most common primary benign cardiac tumors. Although typically asymptomatic, they can manifest with nonspecific symptoms such as dyspnea and dizziness or more acute manifestations such as embolic events. We describe an unusual location of a PFE typically seen with a CM.

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Left atrial masses are most commonly diagnosed as myxomas. When clinicians doubt the diagnosis, a biopsy is warranted. However, this can be very difficult with left-sided tumors.

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Transcatheter mass extraction of left-sided cardiac masses has gained popularity in recent years, with scarce data on effectiveness, safety, and types of devices used. Mostly, left-sided aspirations use mechanical and continuous-flow-mediated devices (the AngioVac [AngioDynamics] and Penumbra systems [Penumbra]). To our knowledge, the use of manual aspiration devices has not been reported yet.

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Enhancing Diagnostic Precision: Intracardiac Echocardiography-Guided Endomyocardial Biopsy for Complex Right Atrial Mass.

JACC Case Rep

December 2024

Department of Cardiology, Centro Hospitalar Universitário Lisboa Norte,Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), Faculdade de Medicina da Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.

An 80-year-old woman with a history of B-cell non-Hodgkin lymphoma presented to the emergency department with exertional dyspnea and lower limb edema. A transthoracic echocardiogram revealed a large extracardiac mass invading the right atrium. A diagnostic transcatheter endomyocardial biopsy guided by intracardiac echocardiography was performed.

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