A case report of mass and pressure: the utility of contrast echocardiography

BACKGROUND: Diagnostic dilemmas in an unwell neonate can require the use of enhanced imaging modalities, especially in post-operative cardiac disease. CASE SUMMARY: A neonate presented a diagnostic challenge following the repair of complex transposition of the great arteries, when an echogenic mass was noted in the region of the left atrial appendage on two-dimensional echocardiography, in the context of a monitoring line (left atrial line) inserted directly through this area. Although the pressure monitoring on this line suggested elevated left atrial pressure, the neonate was clinically and haemodynamically stable. Contrast echocardiography was used to investigate this further and found the mass to be extracardiac. CONCLUSION: Contrast echocardiography is a simple and readily available tool for further echocardiographic delineation of structures, although needs to be performed carefully and the results interpreted logically.