PMC6450235_01
The TE echocardiogram: (a) X-plane vision showing a thrombus inside the appendage of the LA and a limited image that comes from the posterolateral wall to the mitral valve plane without any communication with the atrial chamber; (b) increased velocity of the color Doppler at the level of the mitral inflow. LV = left ventricle, LA = left atrium; Ao = ascending aorta; TE = Transesophageal
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F1
Angio-CT: capsuled lesion of the posterolateral left atrial wall to mitral annulus with clear margins, but no contrast enhancement both in the arterial (a) and the late phases (b). LV = left ventricle, LA = left atrium, CT = Computed tomography
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F2
Cardiac MR: the intramural formation in the context of the lower lateral wall of the LA, occupying the chamber, by causing obstruction to ventricular filling but in the absence of signs of local invasiveness (a). It was characterized by a marked hyperintensity on T2-weighted images (b). LV = left ventricle, LA = left atrium, RV = right ventricle, MR = Magnetic resonance
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F3
These findings were deemed compatible with the original hypothesis of an intramural hematoma of the wall of the atrium, probably subacute/chronic [Figure 3].
Histological examination: a hematoxylin and eosin stain confirmed the presence of histiocytes, crenated red blood cells, and crystals, which are typical findings of a chronic hematoma
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F4