Complex right atrial mass in endomyocardial fibrosis: a diagnostic dilemma

BMJ Case Rep. 2019 Jan 4;12(1):e227131. doi: 10.1136/bcr-2018-227131.

Abstract

Endomyocardial fibrosis, though a vanishing disease from India, remains an important cause of heart failure in children, adolescents and young adults. It may be complicated with arrhythmias and thromboembolism and is an important cause of mortality and morbidity. Moreover, usual presentation of this condition is in advanced stage with poor prognosis. Ventricular endocardial fibrosis with organised thrombus is the hall mark of this entity. Presence of associated cardiac mass poses a diagnostic challenge. We present one such case of endomyocardial fibrosis, in which a large thrombus was seen adherent to the anterolateral wall of right atrium, posing further risk of thromboembolism with complex management issues.

Keywords: cardiovascular system; radiology (diagnostics).

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Adult
  • Anticoagulants / administration & dosage
  • Anticoagulants / therapeutic use
  • Atrial Fibrillation / diagnosis
  • Endomyocardial Fibrosis / complications*
  • Endomyocardial Fibrosis / physiopathology
  • Female
  • Heart Atria / diagnostic imaging
  • Heart Atria / pathology*
  • Heart Atria / physiopathology
  • Heart Failure / diagnosis
  • Heart Failure / etiology
  • Humans
  • Magnetic Resonance Imaging / methods
  • Pulmonary Embolism / drug therapy
  • Pulmonary Embolism / prevention & control*
  • Rare Diseases
  • Thrombosis / diagnostic imaging
  • Thrombosis / pathology*
  • Treatment Outcome

Substances

  • Anticoagulants