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Revealing the etiology of a left ventricular mass using cardiac magnetic resonance

A 59-year-old female with history of breast and ovarian CA was being evaluated because of an incidentally noted left ventricular mass on a routine follow-up breast MRI. Transthoracic and transesophageal echocardiograms detected a large pedunculated LV mass (6.4cm x 2.4cm) attached to the apex. A cardiac MRI was done to better characterize the mass. Spin echo weighted T1 and T2 sequences demonstrated a large cylindrical mass attached to the apex, nearly iso-intense with the myocardium that does not thicken with systole. Inversion recovery imaging sequence timed to null thrombus confirmed the mass to be a thrombus. Delayed enhancement imaging showed an antero-lateral-apical scar consistent with distal left anterior descending (LAD) artery infarct of the anterior left ventricular wall. The patient had no history of a prior MI and had no previous ischemic cardiac work up. Herein, we describe a rare case of an exceptionally large intracavitary thrombus overlying an apical infarct detected only by cardiac MRI in a patient with a probable hypercoagulable state from ovarian CA.

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Correspondence to Tarek M Mousa.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Mousa, T.M., Kozeski, G., M Rizwan, K. et al. Revealing the etiology of a left ventricular mass using cardiac magnetic resonance. J Cardiovasc Magn Reson 12, T5 (2010). https://doi.org/10.1186/1532-429X-12-S1-T5

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Keywords

  • Cardiac Magnetic Resonance
  • Leave Anterior Descend
  • Left Ventricular Mass
  • Left Ventricular Wall
  • Leave Anterior Descend