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Left atrial thrombus mimicking myxoma in a patient with hereditary hemorrhagic telangiectasia: Diagnostic and therapeutic dilemmas

Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder characterized by the development of arteriovenous malformations. The arteriovenous shunts may result in high output heart failure, which predisposes to atrial dilatation and atrial fibrillation. Due to recurrent bleeding f...

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Autores principales: Shahandeh, Negeen, Shemin, Richard J., McWilliams, Justin P., Moriarty, John M., Prosper, Ashley E., Tobis, Jonathan M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7452037/
https://www.ncbi.nlm.nih.gov/pubmed/32874383
http://dx.doi.org/10.1016/j.radcr.2020.07.050
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author Shahandeh, Negeen
Shemin, Richard J.
McWilliams, Justin P.
Moriarty, John M.
Prosper, Ashley E.
Tobis, Jonathan M.
author_facet Shahandeh, Negeen
Shemin, Richard J.
McWilliams, Justin P.
Moriarty, John M.
Prosper, Ashley E.
Tobis, Jonathan M.
author_sort Shahandeh, Negeen
collection PubMed
description Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder characterized by the development of arteriovenous malformations. The arteriovenous shunts may result in high output heart failure, which predisposes to atrial dilatation and atrial fibrillation. Due to recurrent bleeding from epistaxis or the gastrointestinal tract, patients with HHT and atrial fibrillation are at high risk of bleeding if anticoagulated for stroke prevention. In this report, we present a case of a 74-year-old woman with a history of HHT and atrial fibrillation who developed a large left atrial thrombus that initially was thought to represent an atrial myxoma. The diagnosis was confirmed with cardiac magnetic resonance imaging, and the patient underwent surgical resection of the thrombus. This case demonstrates the role of different imaging modalities in the assessment of left atrial masses and presents an opportunity to review the data on safety of anticoagulation in patients with HHT.
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spelling pubmed-74520372020-08-31 Left atrial thrombus mimicking myxoma in a patient with hereditary hemorrhagic telangiectasia: Diagnostic and therapeutic dilemmas Shahandeh, Negeen Shemin, Richard J. McWilliams, Justin P. Moriarty, John M. Prosper, Ashley E. Tobis, Jonathan M. Radiol Case Rep Cardiac Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder characterized by the development of arteriovenous malformations. The arteriovenous shunts may result in high output heart failure, which predisposes to atrial dilatation and atrial fibrillation. Due to recurrent bleeding from epistaxis or the gastrointestinal tract, patients with HHT and atrial fibrillation are at high risk of bleeding if anticoagulated for stroke prevention. In this report, we present a case of a 74-year-old woman with a history of HHT and atrial fibrillation who developed a large left atrial thrombus that initially was thought to represent an atrial myxoma. The diagnosis was confirmed with cardiac magnetic resonance imaging, and the patient underwent surgical resection of the thrombus. This case demonstrates the role of different imaging modalities in the assessment of left atrial masses and presents an opportunity to review the data on safety of anticoagulation in patients with HHT. Elsevier 2020-08-18 /pmc/articles/PMC7452037/ /pubmed/32874383 http://dx.doi.org/10.1016/j.radcr.2020.07.050 Text en © 2020 The Authors. Published by Elsevier Inc. on behalf of University of Washington. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Cardiac
Shahandeh, Negeen
Shemin, Richard J.
McWilliams, Justin P.
Moriarty, John M.
Prosper, Ashley E.
Tobis, Jonathan M.
Left atrial thrombus mimicking myxoma in a patient with hereditary hemorrhagic telangiectasia: Diagnostic and therapeutic dilemmas
title Left atrial thrombus mimicking myxoma in a patient with hereditary hemorrhagic telangiectasia: Diagnostic and therapeutic dilemmas
title_full Left atrial thrombus mimicking myxoma in a patient with hereditary hemorrhagic telangiectasia: Diagnostic and therapeutic dilemmas
title_fullStr Left atrial thrombus mimicking myxoma in a patient with hereditary hemorrhagic telangiectasia: Diagnostic and therapeutic dilemmas
title_full_unstemmed Left atrial thrombus mimicking myxoma in a patient with hereditary hemorrhagic telangiectasia: Diagnostic and therapeutic dilemmas
title_short Left atrial thrombus mimicking myxoma in a patient with hereditary hemorrhagic telangiectasia: Diagnostic and therapeutic dilemmas
title_sort left atrial thrombus mimicking myxoma in a patient with hereditary hemorrhagic telangiectasia: diagnostic and therapeutic dilemmas
topic Cardiac
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7452037/
https://www.ncbi.nlm.nih.gov/pubmed/32874383
http://dx.doi.org/10.1016/j.radcr.2020.07.050
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