title: Left ventricular mass: A tumor or a thrombus diagnostic dilemma.
abstract: Left ventricular (LV) mass is a rare condition, of which the most common is thrombus. Echocardiography is a very useful modality of investigation to evaluate the LV mass. We are reporting a case of LV mass presenting with neurological symptom. The diagnosis of this mass was dilemma as the echocardiographic features were favoring tumor as well as thrombi. Mass (a) measuring 3.8 cm × 1.9 cm attached to the left ventricle apex appeared to be pedunculated tumor and mass (b) measuring 2.4 cm × 1.8 cm attached to the chordae of anterior mitral leaflet resembled a thrombus or an embolized tumor entangled in the chordae. A differential diagnosis for the LV mass is thrombus, tumors such as fibroma, and vegetation. Preoperative detection of a thrombus leads to an alteration in surgical steps. A large and mobile thrombus with or without a hemodynamic alteration is an indication for surgical removal to prevent stroke, myocardial infarction, mesenteric ischemia, renal infarction, gangrene of the limbs, and mortality.
authors.affiliation: Department of Cardiac Thoracic and Vascular Anesthesia, JSS Super Speciality Hospital and Medical College, Mysore, Karnataka, India.
authors.forename: U S
authors.initials: US
authors.lastname: Dinesh Kumar
authors.affiliation: Department of Cardio Vascular and Thoracic Surgery, JSS Super Speciality Hospital and Medical College, Mysore, Karnataka, India.
authors.forename: Shyam Prasad
authors.initials: SP
authors.lastname: Shetty
authors.affiliation: Department of Cardio Vascular and Thoracic Surgery, JSS Super Speciality Hospital and Medical College, Mysore, Karnataka, India.
authors.forename: K R
authors.initials: KR
authors.lastname: Sujay
authors.affiliation: Department of Cardiac Thoracic and Vascular Anesthesia, JSS Super Speciality Hospital and Medical College, Mysore, Karnataka, India.
authors.forename: Murugesh
authors.initials: M
authors.lastname: Wali
mesh_terms: D000328:Adult; D020520:Brain Infarction / Q000150:complications / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D006338:Heart Neoplasms; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D018908:Muscle Weakness / Q000150:complications / Q000503:physiopathology; D013927:Thrombosis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D034941:Upper Extremity / Q000503:physiopathology