PMC8634327_01
Non-invasive diagnostic workup including ECG, echocardiography, DE-CMR, and CT.
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F1
The electrocardiogram (ECG) showed sinus tachycardia, normal electrical heart axis and normal PR- and QRS-intervals, but inverted T-waves in both antero- and inferolateral leads (Figure 1). A further decrease in hemoglobin (4.7 mmol/L) was noted and TTE showed recurrent circumferential pericardial effusion (~3 cm) but now a dense structure suggesting thrombus in the pericardial sac (Figure 1). On the delayed enhancement (DE) images, the high intra-pericardial signal again suggested contrast-extravasation into the pericardial sac, whereas an extensive, hypo-enhanced circumferential layer against the inner parietal pericardium suggested thrombus (Figure 1).
Figure showcasing the timeline of events.
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F2
A timeline is showcased in Figure 2.
Invasive diagnostic workup including surgery and histopathology, confirming the diagnosis angiosarcoma of the heart.
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F3
Microscopic evaluation of this lesion revealed transmural invasion of the angiosarcoma (Figure 3).