title: An atrial mass:  the value of echocardiographic three-dimensional reconstruction.
abstract: An 88-year-old lady was referred to our Heart Failure Clinic with a history of 'occasional' breathlessness. Electrocardiography showed sinus rhythm and no other major abnormalities and N-terminal pro-B-type natriuretic peptide (NT-proBNP) was normal. Transthoracic echocardiography showed a non-dilated left ventricle with good systolic function. A bright and well-circumscribed, echogenic mass appeared inside a mildly dilated left atrium, visible in both parasternal and apical views. A three-dimensional echocardiographic reconstruction showed no mass within the left atrium; however, an extracardiac mass impinging its posterior wall was seen. Suspicion of an intrathoracic tumour was raised and cardiac magnetic resonance showed a hiatus hernia immediately adjacent to the left atrium. Care must be taken when evaluating masses in or close to the heart.
authors.affiliation: Department of Academic Cardiology, Hull and East Yorkshire Medical Research and Teaching Centre, Castle Hill Hospital, Kingston upon Hull, UK. Pierpaolo.Pellicori@hey.nhs.uk
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Pellicori
authors.forename: Nasser
authors.initials: N
authors.lastname: Sherwi
authors.forename: Olga
authors.initials: O
authors.lastname: Khaleva
authors.forename: Kenneth
authors.initials: K
authors.lastname: Wong
authors.forename: John G F
authors.initials: JG
authors.lastname: Cleland
mesh_terms: D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D003937:Diagnosis, Differential; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006338:Heart Neoplasms / Q000000981:diagnostic imaging*; D006551:Hernia, Hiatal / Q000000981:diagnostic imaging*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011237:Predictive Value of Tests; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain