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Left ventricular apical mass after myocardial infarction—not always a thrombus: a diagnostic dilemma
  1. Jayanty Venkata Balasubramaniyan1,
  2. Judah Nijas Arul1,
  3. Jebaraj Rathinasamy1 and
  4. Thangavel Periyasamy2
  1. 1Cardiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
  2. 2Cardiothoracic and Vascular Sugery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
  1. Correspondence to Judah Nijas Arul; judah.n.arul{at}gmail.com

Abstract

Myxomas arising from the left ventricle (LV) are extremely rare and can be easily mistaken for a thrombus. We report a case of a 35-year-old man who presented with an acute cerebrovascular accident, having had a prior history of an anterior wall myocardial infarction 2 years back with an echocardiographic evaluation showing mild LV systolic dysfunction. His present prothrombotic workup revealed hyperhomocystinaemia and elevated levels of factor VIII. Present echocardiography revealed a mass arising from a scarred LV wall. Considering the possibility of a thrombus, he was initially started on parenteral anticoagulation. Unfortunately, consequent echocardiogram evaluation showed no reduction in size of the LV mass hence surgical removal was done. Histopathological evaluation unveiled the mass to be a myxoma.

  • ischaemic heart disease
  • cardiovascular medicine
  • stroke
  • cardiothoracic surgery

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Footnotes

  • Contributors JNA was responsible for the original draft with inputs from all the authors; JVB and RJ were responsible for review and editing of the final manuscript. JVB and TP were responsible for conceptualisation and overall supervision of the care and treatment.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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