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Șoșdean R, Lazăr MA, Pescariu SA, Mircea MN, Lala RI, Mornoș C, Luca CT, Ionac A. Importance of Multimodality Cardiac Imaging in the Diagnosis of Lipomatous Hypertrophy of the Interatrial Septum-A View beyond Standard Situations. Life (Basel) 2024; 14:514. [PMID: 38672784 PMCID: PMC11051309 DOI: 10.3390/life14040514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/10/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
Lipomatous hypertrophy of the interatrial septum (LHIAS) represents a benign proliferation of lipoid cells at the level of the interatrial septum (IAS) inducing an important thickening of this structure. It respects the fossa ovalis (FO) region, having a typical "hourglass" echocardiographic appearance. There are certain cases though, with unusual appearances and/or with associated pathologies that may induce similar lesions in the heart, in which the differential diagnosis cannot be guaranteed using only the standard methods. The final diagnosis has important implications in these patients' treatment plan. In this paper, we present an unusual case of a female patient undergoing chemotherapy for lung carcinoma, suspected of right atrial thrombosis/metastasis. As the diagnosis was unclear after transthoracic echocardiography (TTE), inducing the suspicion of an IAS mass with atrial wall infiltration, bi- and tridimensional transesophageal echocardiography (TOE) was performed, revealing a severely and homogenously hypertrophied IAS respecting the FO, but lacking a clear visualization of the atrial wall. The diagnosis of LHIAS was established by cardiac magnetic resonance (CMR) that certified the adipose nature of the structure, excluding the need for invasive investigations and/or treatment options. Multimodality imaging is very important for the clinician in adopting the best management plan for each individual patient.
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Affiliation(s)
- Raluca Șoșdean
- Department VI—Cardiology, “Victor Babeș” University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania; (R.Ș.); (M.-A.L.); (C.M.); (C.T.L.), (A.I.)
- Institute of Cardiovascular Diseases, 300310 Timișoara, Romania;
| | - Mihai-Andrei Lazăr
- Department VI—Cardiology, “Victor Babeș” University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania; (R.Ș.); (M.-A.L.); (C.M.); (C.T.L.), (A.I.)
- Institute of Cardiovascular Diseases, 300310 Timișoara, Romania;
| | - Silvius Alexandru Pescariu
- Department VI—Cardiology, “Victor Babeș” University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania; (R.Ș.); (M.-A.L.); (C.M.); (C.T.L.), (A.I.)
- Institute of Cardiovascular Diseases, 300310 Timișoara, Romania;
| | | | - Radu Ioan Lala
- Department of Cardiology, Faculty of Medicine, Arad Emergency County Hospital, Arad Western University “Vasile Goldis”, 310025 Arad, Romania;
| | - Cristian Mornoș
- Department VI—Cardiology, “Victor Babeș” University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania; (R.Ș.); (M.-A.L.); (C.M.); (C.T.L.), (A.I.)
- Institute of Cardiovascular Diseases, 300310 Timișoara, Romania;
| | - Constantin Tudor Luca
- Department VI—Cardiology, “Victor Babeș” University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania; (R.Ș.); (M.-A.L.); (C.M.); (C.T.L.), (A.I.)
- Institute of Cardiovascular Diseases, 300310 Timișoara, Romania;
| | - Adina Ionac
- Department VI—Cardiology, “Victor Babeș” University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania; (R.Ș.); (M.-A.L.); (C.M.); (C.T.L.), (A.I.)
- Institute of Cardiovascular Diseases, 300310 Timișoara, Romania;
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Wang H, Sun Z, Xu L. Cardiovascular magnetic resonance shows promise in grading cardiac tumors. Int J Cardiol 2021; 332:225-226. [PMID: 33753186 DOI: 10.1016/j.ijcard.2021.03.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 03/10/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Hui Wang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zhonghua Sun
- Discipline of Medical Radiation Sciences, Curtin Medical School, Curtin University, Perth, WA 6845, Australia
| | - Lei Xu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
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