A 75-year-old man underwent elective biological aortic valve replacement. Two weeks after surgery, transthoracic echocardiography (TTE) showed a small pericardial effusion. On the following day, the patient suffered from syncope. A repeated TTE revealed a "giant" echo-dense mass (90x80 mm) occupying the entire right atrium and severely limiting tricuspid valve inflow. Although the initial differential diagnosis included the development of an intracavitary process, the rapidly-growing mass with a characteristic echo‑lucent layer at its atrial aspect (consistent with the atrial wall and visceral pericardium) (arrows) led to the final diagnosis of a pericardial hematoma mimicking a huge atrial mass. Emergency surgical exploration confirmed the diagnosis.
Figure 1.
Transthoracic echocardiography: giant eco-dense mass occupying the entire right atrium (Panel A) and severely limiting tricuspid valve inflow (Panel B). Atrial wall and visceral pericardium (arrows)
Footnotes
Sources of Funding
There were no external funding sources for this study.
Study Association
This study is not associated with any thesis or dissertation work.