PMC7537681_01
Electrocardiogram on presentation shows sinus rhythm, complete heart block with junctional escape rhythm.
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The electrocardiogram (ECG) demonstrated sinus rhythm, complete heart block with a junctional escape rhythm (Figure 1).
Chest X-ray single view with right jugular transvenous pacing wire with lead terminating in the right ventricle. There is a loop of the transvenous pacing wire seen within the right atrium.
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Chest X-ray showed looping of the lead in the right atrium while pacing the right ventricular apex (Figure 2).
Apical four chamber from the transthoracic echocardiogram demonstrating a mass in the right atrium approximately 3-4 cm in size involving the interatrial septum.
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Transthoracic echocardiography revealed a hyperechoic dense structure in the right atrium (Figure 3).
Four chamber view from the cardiac computed tomography angiogram demonstrating the mass invading the interatrial septum and inlet ventricular septum, and extending into the tricuspid annulus as well.
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Therefore, cardiac computed topography angiography (CCTA) was performed and characterized the right atrial mass measuring 6.6 x 4.8 cm with Hounsfield units similar to myocardium without vascularization (Figure 4).