An unusual presentation of a right atrial Chiari network

The Chiari Network—Only an Embryonic Remnant or a Confusing Finding?

“…Although the Chiari network was first described in 1875 by von Rokitansky, it did not earn its name until 1897, when a pathologist named Hans Chiari published his work identifying the meshwork in the right atrium of 11 human cadavers. [2][3][4] This net is defined as an embryonic vestige that results from incomplete reabsorption of the right valve of the sinus venosus, connecting the edges of inferior vena cava and coronary sinus valve with other right atrium structures. [1][2][3][5][6][7] Both transthoracic and transesophageal echocardiography are reliable tools for diagnosing Chiari network.…”

“…For example, it should be differentiated from a tricuspid valve disruption, vegetation, thrombus, or tumoral mass. 1 -5…”

“…For example, it should be differentiated from a tricuspid valve disruption, vegetation, thrombus, or tumoral mass. [1][2][3][4][5] A seven-year-old boy was evaluated in the emergency department for a 48-hour history of fever, pain, and functional limitation of his right arm. On physical examination, the upper right arm was warm with edema and erythema.…”

“…3 Depending on the clinical context, a simple Chiari network could be misinterpreted as other pathologic elements such as a pedunculated tumor, a thrombus, a vegetation, a ruptured chordae tendinae, or a flail tricuspid leaflet. 1,2,4 In addition, the Chiari network has been considered a potential source for septic pulmonary emboli [1][2][3]5,7 and, paradoxically, it has also been thought to prevent massive pulmonary embolism by acting as an anatomic barrier. 2,8 In some instances, catheters, guidewires, and pacemaker leads may get entrapped within its net.…”