left atrial and left atrial appendage mass diagnosed by cardiac imaging: a case report

introduction left atrial thrombi are present in one third of patients with severe rheumatic mitral stenosis and atrial fibrillation. a left atrial mass can be diagnosed as a thrombus by transthoracic echocardiography in the presence of the predisposing factors for a thrombus such as mitral stenosis and atrial fibrillation. the sensitivity of transthoracic echocardiography for detecting left atrial appendage thrombi is low, and only a few case reports have been described in the literature. conclusions transthoracic echocardiography was sufficient to establish the diagnosis and to decide its management. case presentation this report describes the case of a 65-year-old female with severe rheumatic mitral stenosis and chronic atrial fibrillation presenting with congestive heart failure. this patient was shown, by means of transthoracic echocardiography, to have a large immobile left atrium cavity mass (6.5 × 3.4 × 2.3 cm) and a large left atrial appendage mass (1.7 cm) identified as a thrombus. contrast computed tomography of the chest confirmed the diagnosis.