The online version of this article (doi:10.1186/1476-7120-7-4) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
MD performed the echocardiography. AM was the treating physician. Both authors contributed to the manuscript and approved the final version.
Primary intracardiac tumours are rare, there are however several entities that can mimic tumours. Contrast echocardiography has been suggested to aid the differentiation of various suspected masses. We present a case where transthoracic echocardiography completely misdiagnosed a left atrial mass, partly due to use of echo contrast.
An 80 year-old woman was referred for transthoracic echocardiography because of one-month duration of worsening of dyspnoea. Transthoracic echocardiography displayed a large echodense mass in the left atrium. Intravenous injection of contrast (SonoVue, Bracco Inc., It) indicated contrast-enhancement of the structure, suggesting tumour. Transesophageal echocardiography revealed, however, a completely normal finding in the left atrium. Subsequent gastroscopy examination showed a hiatal hernia.
It is noteworthy that the transthoracic echocardiographic exam completely misdiagnosed what seemed like a left atrial mass, which in part was an effect of the use of echo contrast. This example highlights that liberal use of transoesophageal echocardiography is often warranted if optimal display of cardiac structures is desired.
Additional file 1: Movie of transthoracic echocardiography from parasternal long-axis view. The movie shows the rather large hiatal hernia. (AVI 5 MB)12947_2008_251_MOESM1_ESM.avi
Additional file 2: Movie of transthoracic echocardiography from apical four-chamber view. The movie shows the rather large hiatal hernia. (AVI 6 MB)12947_2008_251_MOESM2_ESM.avi
Additional file 3: Movie of transthoracic echocardiography from apical four-chamber view after injection of echo contrast. Note what appears to be irregular contrast uptake within the structure in the left atrium. (AVI 4 MB)12947_2008_251_MOESM3_ESM.avi
Authors’ original file for figure 112947_2008_251_MOESM4_ESM.bmp
Authors’ original file for figure 212947_2008_251_MOESM5_ESM.bmp
Authors’ original file for figure 312947_2008_251_MOESM6_ESM.bmp
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