Methodist Journal

IN THIS ISSUE

Nutritional Supplements and the Heart

Vol 15, Issue 3 (2019)


FEATURED GUEST EDITOR

ISSUE INTRO

Dietary Supplements: Facts and Fallacies

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RECOGNITIONS

Drs. Raizner and Cooke Take the Lead in Special Issue on Supplements

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REVIEW ARTICLES See More

Recent Clinical Trials Shed New Light on the Cardiovascular Benefits of Omega-3 Fatty Acids

Supplemental Vitamins and Minerals for Cardiovascular Disease Prevention and Treatment

Coenzyme Q10

Red Yeast Rice for Hypercholesterolemia

Inorganic Nitrate Supplementation for Cardiovascular Health

Vitamin D and Calcium Supplements: Helpful, Harmful, or Neutral for Cardiovascular Risk?

Cardiovascular Risk of Proton Pump Inhibitors

Advanced Cardiac Imaging for Complex Adult Congenital Heart Diseases

CASE REPORTS See More

A Rare Case of Pancreatitis-Induced Thrombosis of the Aorta and Superior Mesenteric Artery

Anomalous Origin of the Right Coronary Artery from the Left Main Coronary Artery in the Setting of Critical Bicuspid Aortic Valve Stenosis

Simultaneous Transfemoral Mitral and Tricuspid Valve in Ring Implantation: First Case Report with Edwards Sapien 3 Valve

Uneventful Follow-Up 2 Years after Endovascular Treatment of a High Flow Iatrogenic Aortocaval Fistula Causing Pulmonary Hypertension and Right Heart Failure

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER See More

Snoopy’s Heart: A Case of Complete Congenital Absence of the Pericardium

CLINICAL PERSPECTIVES See More

POINTS TO REMEMBER

Herbal Nephropathy

EXCERPTA

Rolling the Dice on Red Yeast Rice

POINTS TO REMEMBER

The Kidney in Congenital Cyanotic Heart Disease

EXCERPTA

Talking Statins with Antonio Gotto

EDITORIALS

Letter to the Editor in Response to “Cardiac Autonomic Neuropathy in Diabetes Mellitus”

Vol 13, Issue 4 (2017)

Article Full Text

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER

Incidental Finding of a Cardiac Mass on Abdominal CT Scan

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Article Citation:

Ahmad J, Alshammari BS, Nabi F. Incidental Finding of a Cardiac Mass on Abdominal CT Scan. Methodist DeBakey Cardiovasc J. 2017;13(4):253.

doi: 10.14797/mdcj-13-4-253

Keywords
cardiac fibroma , cardiac tumor , cardiac magnetic resonance imaging , CMR

A 21-year-old woman presented to our hospital with symptoms of nausea, vomiting, abdominal pain, and fever. She underwent abdominal computed tomography (CT) to evaluate the abdominal pain, and a mass was discovered incidentally at the left ventricular cardiac apex. She denied any cardiac symptoms.

Further evaluation through cardiac magnetic resonance imaging (CMR) showed a large, well-encapsulated intramuscular mass in the left ventricle apex measuring up to 2 cm 3 cm (Figures A, B). Tissue characterization revealed that the mass was isointense to myocardium on T1-weighted images (Figure C) and hypointense on T2-weighted images (Figure D). On late gadolinium-enhanced (LGE) images, there was marked hyperenhancement, which was characteristic of a cardiac fibroma (Figures E, F).

Cardiac fibromas are benign primary tumors composed of fibroblasts and a large amount of collagen. These uncommon tumors are primarily found in the pediatric population, and their prevalence among adults is rare.1,2 Mainly located in the ventricular septum or left ventricular wall (intramural),3 these tumors have much extracellular space for gadolinium accumulation, resulting in intense enhancement on CMR LGE images. A cardiac fibroma may lead to congestive heart failure or invade conduction tissue and cause ventricular arrhythmias.4 Surgical resection is indicated in symptomatic patients.

Our patient remains asymptomatic and is monitored closely for symptoms. Repeat CMR imaging at 6 months demonstrated no change of the mass, suggesting that the lesion is benign.

References

1. Stéphant E, Ana S, Philippe D. Inter-ventricular septal cardiac fibroma in an adult: MR and MDCT features with pathologic correlation. Eur J Radiol Extra. 2008 Sep;67(3):e103-6.

2. Yu K, Liu Y, Wang H, Hu S, Long C. Epidemiological and pathological characteristics of cardiac tumors: a clinical study of 242 cases. Interact Cardiovasc Thorac Surg. 2007 Oct;6(5):636-9.

3. Padalino MA, Basso C, Milanesi O, et al. Surgically treated primary cardiac tumors in early infancy and childhood. J Thorac Cardiovasc Surg. 2005 Jun;129(6):1358-63.

4. Becker AE. Primary heart tumors in the pediatric age group: a review of salient pathologic features relevant for clinicians. Pediatr Cardiol. 2000 Jul-Aug;21(4):317-23.

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