PMC6116406_01
Still images of echocardiogram form the initial diagnosis and subsequent recurrent CM, panel (a) showing a LA mass during initial diagnosis; panel (b) showing LA and LV masses in the first recurrent episode; panel (c) showing an RV mass in the second recurrent episode; panel (d) showing LA, LV, and RV masses in the third recurrent episode.
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fig1
The mass was mobile, heterogeneous, and protruded from atrial septum into LA, suspected for CM and causing mitral regurgitation (Figure 1). Echocardiogram showed multiple cardiac masses in LA (2.5 x 1.9 cm) and left ventricular (LV) (1.8 x 1.0 cm) (Figure 1). She was asymptomatic but with the follow-up echocardiogram showing increasing in size of the mass to 2.8 x 4.7 cm extended into RV outflow tract causing obstruction (peak RV outflow velocity of 3.8 m/s) (Figure 1). There were recurrent of cardiac masses in LA, LV, and RV, sized 2.4 cm, 2.1 cm, and 2.4 cm, respectively (Figure 1).
PMC6116406_02
The gross examination of the explant heart showing multiple gelatinous masses (arrows).
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fig2
The gross examination of the excision heart showed 4, 1, and 1 masses in RV, LA, and LV (Figure 2).