Methodist Journal

IN THIS ISSUE

Lipids and Lipoproteins

Vol 15, Issue 1 (2019)


FEATURED GUEST EDITOR

ISSUE INTRO

Lipids and Cardiovascular Disease: Putting it All Together

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RECOGNITIONS

Guest Editors Henry Pownall and Antonio Gotto Offer Insight and Expertise on the topic of Lipids and Cardiovascular Disease

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REVIEW ARTICLES See More

Cholesterol: Can’t Live With It, Can’t Live Without It

How Much Do Lipid Guidelines Help the Clinician? Reading Between the (Guide)lines

Statins: Then and Now

Poststatin Lipid Therapeutics: A Review

HDL and Reverse Cholesterol Transport Biomarkers

Revisiting Reverse Cholesterol Transport in the Context of High-Density Lipoprotein Free Cholesterol Bioavailability

High-Density Lipoprotein Subspecies in Health and Human Disease: Focus on Type 2 Diabetes

Gene Delivery in Lipid Research and Therapies

CASE REPORTS See More

Device-Related Thrombus: A Reason for Concern?

Retained Coronary Balloon Requiring Emergent Open Surgical Retrieval: An Uncommon Complication Requiring Individualized Management Strategies

Loperamide Mimicking Brugada Pattern

Reversed Pulsus Paradoxus in Right Ventricular Failure

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER See More

Transcatheter Embolization of a Persistent Vertical Vein: A Rare Cause of Left-to-Right Shunt and Right-Sided Heart Failure

CLINICAL PERSPECTIVES See More

EXCERPTA

Talking Statins with Antonio Gotto

POINTS TO REMEMBER

Lipids and Renal Disease

EXCERPTA

Addressing the Feedback Loop Between Depression, Diabetes, and Cardiovascular Disease

POINTS TO REMEMBER

The Kidney as an Endocrine Organ

EDITORIALS

Addressing the Underrepresentation of Women in Cardiology through Tangible Opportunities for Mentorship and Leadership

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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