Right Atrial Mass in a Man With Left Main Pulmonary Artery Embolism

A man in his mid-50s with a medical history of pulmonary embolism 10 years prior presented to the emergency department with 10 days of progressively worsening, sharp, nonradiating chest pain. Results of physical examination were normal. His electrocardiogram showed normal sinus rhythm with evidence of right heart strain, and troponin levels were normal. A chest computed tomography angiogram demonstrated an occlusive pulmonary embolism of the left main pulmonary artery and several peripheral consolidations in the left lower lung field, consistent with infarction.

This echocardiogram video shows bowing of the interventricular septum into the left ventricle and a large (6.6 × 4.1-cm), mobile, nonhomogeneous, pedunculated mass straddling the tricuspid valve and moving between the right atrium and right ventricle.

The patient was treated surgically with resection of the mass and embolism, which were diagnosed on pathology as being myxomatous.

Click the Related Article link for complete case details and a review of cardiac myxomas.