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(Circulation. 2004;109:e165-e166.)
© 2004 American Heart Association, Inc.

Images in Cardiovascular Medicine

Prolapsing Atrial Myxoma

Dynamic Visualization With Multislice Computed Tomography

Gudrun Feuchtner, MD; Silvana Mueller, MD; Johannes Bonatti, MD; Guy Friedrich, MD; Dieter zur Nedden, MD; Alexander Smekal, MD

From the Department of Radiology II (G.F., D.z.N., A.S.), Department of Cardiology (S.M., G.F.), and Department of Cardiothoracic Surgery (J.B.), University Hospital of Innsbruck, Austria.

Correspondence to Gudrun Feuchtner, MD, Department of Radiology II, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck, Austria. E-mail Gudrun.Feuchtner@uibk.ac.at

An extract of the first 250 words of the full text is provided, because this article has no abstract.

An 80-year-old woman had a history of increasing dyspnea with a sensation of thoracic pressure. Transthoracic echocardiography demonstrated a mobile hyperechoic mass located in the left atrium (Figure 1A) and prolapsing into the left ventricle (Figure 2A). A moderate obstruction of the mitral valve was observed. The mass was suspicious for a cardiac tumor, although an additional thrombus formation could not be excluded. Accordingly, a contrast-enhanced, ECG-gated, 16-row helical CT scan (Sensation 16, Siemens) demonstrated a hypodense mass based on the atrial septum (Figure 1B). Homogenous contrast enhancement suggested a cardiac tumor. Dynamic visualization of the cardiac motion showed the mass based on the atrial septum, prolapsing during diastole into the left ventricle (Figure 2B and Data Supplement Movies). Three-dimensional image reconstruction dependent on heart phase (end diastole and end systole) with ECG gating and high temporal resolution (250 ms) improved preoperative assessment. Surgical removal of the mass proved it to be a myxoma. The postoperative course was uneventful.

View larger version (66K): [in this window] [in a new window]   Figure 1. A, Two-dimensional echocardiography showing a hyperechoic left atrial (LA) mass (arrows) based on the atrial septum (4-chamber view, end systole). The leaflets and cusps of the mitral valve (MV) are not affected. LV indicates left ventricle; RV, right ventricle; RA, right atrium. B, ECG-gated multislice CT demonstrating a hypodense mass (arrows) (4-chamber view, end systole). Three-dimensional reconstruction and display as thin-slice maximum-intensity projection (MIP). Homogenous opacification of cardiac chambers was obtained with a low contrast agent flow rate (1 mL/s) and . . . [Full Text of this Article]

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