Background: Differential diagnosis of left atrial (LA) masses is challenging because there is a significant overlap in the epidemiological, clinical, and imaging characteristics. Even some histological features can be similar across different types of cardiac masses. Therefore, continuous case discussion between the clinician and the pathologist is essential for a correct diagnosis.
Case Summary: We present a case of a patient with a history of cardiac surgery for LA tumour. Histology was compatible with thrombus, although no predisposing causes nor genetic or acquired thrombophilia were identified. After 14 years, the recurrence of LA mass was diagnosed with a routine echocardiography. A review of histological preparations from 2007 with immunohistochemistry techniques not available at that time (calretinin) was consistent with a myxoma. The patient underwent cardiac reoperation with LA mass and interatrial septum excision. Final diagnosis was compatible with a myxoma recurrence.
Discussion: Myxoma is the second most frequent benign primary cardiac tumour. Left atrial thrombi can occasionally mimic the typical echocardiographic appearance of a myxoma, and pathological features can sometimes overlap generating diagnostic confusion. Calretinin fixation is useful for differential diagnosis once it is only identified in myxomas but not in thrombi. Any discrepancy between clinical findings and histology should always mandate a review of histological preparations.
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http://dx.doi.org/10.1093/ehjcr/ytad083 | DOI Listing |
Herzschrittmacherther Elektrophysiol
January 2025
Klinik für Elektrophysiologie/Rhythmologie, Ruhr-Universität Bochum, Bochum, Deutschland.
Atrial fibrillation (AF) ablation is associated with a lower likelihood of death and surgical heart failure (HF) interventions in patients with HF. This effect is mainly driven by reduced all cause and cardiovascular death following ablation. Ablation also results in improved left ventricular (LV) function, decreased AF burden and AF regression.
View Article and Find Full Text PDFRadiol Cardiothorac Imaging
February 2025
From the Department of Cardiology (L.P., W.J., J.L., W.Q., Y.X., Y.K., Q.Z., Y.C.), Department of Geriatrics (K.W.), and Center of Rare Diseases (Y.C.), West China Hospital, Sichuan University, No. 37, Guo Xue Road, Chengdu, Sichuan 610041, China; and Wexner Medical Center, College of Medicine, The Ohio State University, Columbus, Ohio (Y.H.).
Purpose To assess the predictive value of left atrial (LA) fast long-axis strain derived from cardiac MRI for thrombotic events (TEs) in individuals with hypertrophic cardiomyopathy (HCM). Materials and Methods This secondary analysis of an ongoing prospective trial (Chinese Clinical Trial Registry: ChiCTR1900024094) included consecutive participants with HCM without atrial fibrillation (AF) who underwent cardiac MRI from January 2012 to December 2020. The LA fast long-axis strain was obtained by semiautomatically tracking the distance between the atrioventricular junction and the midposterior LA wall.
View Article and Find Full Text PDFCirc Heart Fail
January 2025
Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston (Y.L., J.L.J., G.D.L.).
Background: Objective indices of functional capacity in patients with diabetic cardiomyopathy and stage B heart failure (HF) have not been comprehensively defined. We sought to characterize the cardiopulmonary exercise characteristics of individuals with diabetic cardiomyopathy at high risk for overt HF.
Methods: The relationships from cardiopulmonary exercise testing with clinical and laboratory characteristics of participants with diabetic cardiomyopathy were evaluated using baseline data from the ARISE-HF trial (Aldose Reductase Inhibition for Stabilization of Exercise Capacity in Heart Failure).
Front Cardiovasc Med
January 2025
Department of Cardiology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
Background: Dextrocardia is a rare congenital condition, affecting approximately 1 in 10,000-12,000 individuals. When combined with atrial fibrillation (AF), it becomes even rarer. "One-stop" surgery, including combined radiofrequency ablation (RFA) and left atrial appendage occlusion (LAAO), has become a common clinical treatment for patients with AF who develop cerebral infarction despite regular oral anticoagulants.
View Article and Find Full Text PDFEur Heart J Case Rep
January 2025
Department of Cardiology, Changhai Hospital, Shanghai 200433, China.
Background: Several studies have demonstrated a notable increase in the incidence of atrial arrhythmias among individuals with atrial septal defect (ASD) occluder. Although the sequential dilation technique has been proposed as the mainstream technique for transseptal puncture with ASD occluder, it is associated with substantial risks and technical difficulties.
Case Summary: We report a patient who underwent catheter ablation for atrial fibrillation and had a large ASD occluder.
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