PMC6727231_01
A - Transthoracic echocardiography in apical four-chamber view: the tumour mass in the apex of the left ventricle. B - Coronary angiography: Left anterior descending artery with intermediate lesion in the middle part (white ellipse). C - Fractional flow reserve (FFR). D - Transthoracic echocardiography in apical four-chamber view before vascular surgery: the tumour mass is not clearly visible in the apex of the left ventricle. E - Computed tomography angiography scan: 3D reconstruction of the occlusion of the abdominal aorta (white arrow). F - Cardiovascular magnetic resonance: remnants of thrombus in the apex of the left ventricle (white arrow). LA - left atrium, LV - left ventricle, RV - right ventricle, RA - right atrium.
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A homogeneous pedunculated tumour mass of 4.9 x 1.7 cm attached to the apex of the left ventricle (LV) was revealed in transthoracic echocardiography (TTE) (Figure 1 A). Moderate stenosis in the mid-portion of the left anterior descending artery (LAD) was observed (Figure 1 B). The fractional flow reserve (FFR) was 0.81 (Figure 1 C). TTE (Figure 1 D) and then a computed tomography angiography (CTA) scan (Figure 1 E) were performed, showing the migration of the LV mass and the complete occlusion of the abdominal aorta with embolic material (with moderate density and without contrast enhancement). The patient was immediately transferred for urgent surgery.