Mass in the left atrial appendage: a therapeutic dilemma.
This is a case of a persistent mobile mass in the left atrial appendage in which 3-dimensional transesophageal echocardiography provided excellent definition of the contour of the mass and helped in comparison during follow-up. The mass was incidentally found before atrial fibrillation ablation and initially thought to be a thrombus. As it persisted almost unchanged despite adequate anticoagulation, a tumour such as a fibroelastoma became the leading possibility, presenting us with a management dilemma. Ablation was cancelled, and, because the mass was stable with no embolic sequelae, a conservative approach was adopted. The patient was discharged on long-term anticoagulation.
Department of Cardiology, The Essex Cardiothoracic Centre, Basildon, United Kingdom. Electronic address: arunnatarajann@gmail.com.
Arun
A
Natarajan
Stuart
S
Tan
Hetal N
HN
Patel
Chukwuma
C
Chukwu
Allan
A
Harkness
Stuart
S
Harris
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D020517:Atrial Appendage; D001281:Atrial Fibrillation / Q000150:complications* / Q000175:diagnosis; D017115:Catheter Ablation; D000075202:Contraindications; D003657:Decision Making; D003937:Diagnosis, Differential; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal / Q000379:methods; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008297:Male; D013927:Thrombosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D013997:Time Factors
D000925:Anticoagulants