Urgent Need for Diagnosis of a Rapidly Growing Right Atrial Mass

Thatipelli, Sneha; Raissi, Sasan Ryan; Akhter, Nausheen

doi:10.1001/jamacardio.2020.6107

Cited by 2 publications

(3 citation statements)

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“…Because the atrioventricular node lies in the lowest part of the right atrium, in front of the coronary sinus orifice and directly behind the attachment of the septal leaflet of the tricuspid valve, complete atrioventricular block may be related to the mechanical effect of the vigorous movement of a large prolapsed myxoma on the underlying conduction tissue or its artery. At the same time, marked pressure indentation/distortion of the interventricular septum by the prolapsing tumor may also be the cause of slow atrioventricular conduction . These mechanisms may be supported by the return to normal of atrioventricular conduction after tumor resection in this case.…”

Section: Discussionmentioning

confidence: 56%

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An Unusual Cause of Complete Atrioventricular Block in a Patient With Pedal Swelling

Shou

Cao

2021

JAMA Intern Med

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A patient in their 50s presented to the emergency department with a 6-month history of pedal swelling and a 2-day history of mild dyspnea, denying dizziness and syncope. The patient's initial vital signs were as follows: blood pressure was 136/68 mm Hg; respiratory rate was 19 breaths/min; and pulse rate was 50 beats/min. Physical examination findings revealed symmetrical edema at both lower limbs up to the knees. Blood laboratory test results on admission, including complete blood cell count, kidney function, liver function, electrolytes, thyroid function, and infection indicators, were unremarkable, but high-sensitivity troponin I was 0.056 ng/mL (reference range <0.02 ng/mL; to convert to μg/L, multiply by 1.0). Coronary computed tomographic angiography did not reveal obstructive coronary disease. A transthoracic echocardiography showed a mass attached to the tricuspid orifice of the right atrium. A 12-lead electrocardiogram (ECG) was obtained on admission (Figure , A).Questions: What findings does the ECG show? What is the underlying cause of these findings? What is the appropriate next step in management?

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Section: Discussionmentioning

confidence: 56%

“…Primary cardiac tumors are relatively rare, with a reported incidence rate of less than 0.1% of patients . Myxomas account for 50% of all primary cardiac tumors .…”

Section: Discussionmentioning

confidence: 99%