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01.12.2009 | Case report | Ausgabe 1/2009 Open Access

Cardiovascular Ultrasound 1/2009

How to misuse echo contrast

Zeitschrift:
Cardiovascular Ultrasound > Ausgabe 1/2009
Autoren:
Magnus Dencker, Anna Missios
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1476-7120-7-4) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

MD performed the echocardiography. AM was the treating physician. Both authors contributed to the manuscript and approved the final version.

Abstract

Background

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.

Case presentation

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.

Conclusion

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.
Zusatzmaterial
Additional file 1: Movie of transthoracic echocardiography from parasternal long-axis view. The movie shows the rather large hiatal hernia. (AVI 5 MB)
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Additional file 2: Movie of transthoracic echocardiography from apical four-chamber view. The movie shows the rather large hiatal hernia. (AVI 6 MB)
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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)
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Authors’ original file for figure 1
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Authors’ original file for figure 2
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Authors’ original file for figure 3
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Literatur
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