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CPC 2018
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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
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0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
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CLEAR FILTERS
Left atrial mass: a diagnostic challenge
Session:
Casos Clínicos
Speaker:
Marta Fontes Oliveira
Congress:
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.1 Echocardiography
Session Type:
Casos Clínicos
FP Number:
---
Authors:
Marta Fontes Oliveira; Maria Trêpa; Raquel Baggen Santos; Ricardo Costa; André Dias De Frias; Inês Silveira; Sofia Cabral; Severo Torres
Abstract
<p>62-year-old woman with history of dyslipidemia, arterial hypertension and kidney transplantation 23 years ago due to chronic kidney insufficiency of unknown cause. Medicated with cyclosporine and mycophenolate mofetil. Due to complains of tiredness and precordial oppressive sensation, a transthoracic echocardiography was ordered by her nephrologist. The exam showed a left atrial mass, with irregular edges, very mobile and apparently adherent to the interatrial septum / posterior wall of the left atrium. Left ventricle ejection fraction was normal and the remaining exam was unremarkable. The patient was hospitalized for close surveillance, study of the left atrium mass and surgery planning. She underwent transesophageal echocardiography which confirmed a large sessile mass (2.5 cm diameter), friable and very mobile, non-pediculated with a large base of 1.4 cm, apparently adherent to the transition between left atrium posterior wall and interatrial septum, just above the mitral annulus. During atrial systole, this mass presented slight protrusion into the mitral valve, not exceeding the valvular coaptation plan, causing no obstruction nor significant regurgitation. Although unlikely, the diagnosis of a left atria thrombus could not be excluded and hypocoagulation was started, but the mass size remained similar. Cardiac MRI was also performed, showing high intensity signal on STIR / T2 and T1-weighted images, and heterogeneous mild late contrast enhancement. The mass did not appear to invade adjacent structures, which favored the diagnosis of a benign tumor. Thoracic and abdominal CT did not show signs of any primary tumor. The patient underwent surgery to remove the mass, which required removal of the septum tissue. The surgical piece is currently under pathologic analysis (hopefully, the results will be available in a few days). Cardiac masses are rare and always challenging. Imaging techniques are crucial in their characterization and surgery planning, but only histologic analysis allows a definitive diagnosis.</p>
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