Vital signs were blood pressure of 140/90 mmHg, pulse rate of 70/min, respiration rate of 20 breaths/min, and body temperature of 36.5℃. On the physical examination, cardiac auscultation revealed weak heart sound and electrocardiography demonstrated non-specific depression of ST segment and T wave changes. The blood chemistries, including coagulation see more studies, and lipid profiles were within normal limits.
However, mild anemia (hemoglobin 9.3 mg/dL) and increased level of loctate dehydrogenase (LDH) (787 mg/dL) were noted. Cardiomegaly was noted on Inhibitors,research,lifescience,medical the chest X-ray. Transthoracic echocardiography (TTE) revealed large amount of circumferential pericardial effusion with a normal ejection fraction. The size of the left ventricle and the structure of
cardiac valves were normal (Fig. 1). Contrast-enhanced computed tomography (CT) showed a large amount of pericardial effusion with mass (Fig. 1), calcifications in the mid portion of left anterior descending Inhibitors,research,lifescience,medical (LAD) coronary artery, and small bilateral pleural effusion. However, the lung, thymus, esophagus were unremarkable. Abdominal CT, mammography, and gastroduodenoscopy did not indicate Inhibitors,research,lifescience,medical an extra-cardiac malignancy. Because of concern about the possibility of primary or secondary cardiac or pericardial malignant disease, we recommended pericardiostomy and biopsy. The tissue specimens Inhibitors,research,lifescience,medical yield nonspecific histopathologic finding of mild fibrosis and lymphocytic infiltrations. Fig. 1 Transthoracic echocardiography (A: parasternal long axis view, and B: parasternal short axis view) revealed large amount circumferential pericardial effusion (arrows). Contrast-enhanced computed tomography (C) showed a large pericardial effusion with … After 2 months follow up in out-patient department, she complained of dyspnea again. TTE showed a 3.5×10 cm-sized inhomogeneous mass between left atrium and aortic valve area (Fig. 2). Left ventricular systolic function was normal and the evidence of hemodynamic compromise was not found. Chest CT demonstrated Inhibitors,research,lifescience,medical a 3.7×9.5
cm-sized soft tissue mass, located in transverse sinus between large vessels and upper portion of the left atrium (Fig. 2). Benign conditions like organizing hematoma, abscess, pericardial pheochromocytoma or teratoma Cell press were suspected based on the signal intensity of chest CT. She refused further invasive and non-invasive procedures to confirm the pathology of the mass. Fig. 2 Transthoracic echocardiography (A: parasternal long axis view, and B: parasternal short axis view) revealed a mass (arrows) of inhomogenous echogenecity, located in juxtaaortic valve area. Contrast-enhanced chest CT (C) showed a large soft tissue mass … Dyspnea and chest discomfort aggravated rapidly during hospital admission. Heart rhythm was changed from normal sinus to atrial fibrillation, which might be suggestive of atrial invasion.