title: A diagnostic odyssey: detection of an unusual anterior papillary muscle of the tricuspid valve.
abstract: A routine chest X-ray in a 78-year-old female patient suggested a retained vascular catheter in the right ventricle (RV). On transthoracic echocardiography, a prominent linear echo was found in the RV and the patient was referred for cardiac computed tomography and magnetic resonance imaging. Although neither of these tests showed evidence of a retained foreign body in the RV, they could not clarify the nature of the linear structure within the RV cavity. Finally, transesophageal echocardiography, using a matrix array three-dimensional probe solved the mystery: the linear structure in question within the RV was a large papillary muscle with attachments to the anterior leaflet of the tricuspid valve and an unusual origin from the interventricular septum.
authors.affiliation: Division of Cardiology, Toronto General Hospital, University Health Network, Peter Munk Cardiac Program, University of Toronto, G3-546, 200 Elisabeth Street, Toronto ON M5G 2C4, Canada. patric.biaggi@uhn.on.ca
authors.forename: Patric
authors.initials: P
authors.lastname: Biaggi
authors.forename: Matthias
authors.initials: M
authors.lastname: Greutmann
authors.forename: Andrew
authors.initials: A
authors.lastname: Crean
authors.forename: Melitta
authors.initials: M
authors.lastname: Mezody
authors.forename: Harry
authors.initials: H
authors.lastname: Rakowski
mesh_terms: D000368:Aged; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D005260:Female; D005547:Foreign Bodies / Q000000981:diagnostic imaging / Q000601:surgery*; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000473:pathology*; D006346:Heart Septum / Q000000981:diagnostic imaging / Q000473:pathology*; D006352:Heart Ventricles / Q000002:abnormalities* / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D010210:Papillary Muscles / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014261:Tricuspid Valve / Q000002:abnormalities* / Q000000981:diagnostic imaging