64-year-old woman with mental status changes TTE and MRI in a patient with lipomatous hypertrophy of atrial septum (LHAS). (a) Apical 4-chamber view left ventricle (LV), left atrium (LA) showing massive LHAS particularly notable in the superior limbus. (b) In the 2 chambers view, the LHAS shows extensive mass. (c) In the subcostal view, the clearing of the fossa ovalis (FO) sometimes referred to as the ‘dumbbell’ atrial septal configuration and makes a strong case for the LHAS. (d) Cardiac MRI confirmed echo suspicion of massive LHAS sparing the fossa ovalis in T1-weighted spoiled gradient echo pulse LAVA—water only sequence.
Abbreviations: MRI, magnetic resonance imaging; TTE, transthoracic echocardiography.