Right atrial thrombus masquerading as myxoma
  • Shahad Alchalabi
    Medical University of the Americas, Nevis, Saint Kitts and Nevis
  • Abdulrahman S. Museedi
    Section of Cardiology, Department of Medicine, Tulane University Heart & Vascular Institute, New Orleans, USA


Right atrial thrombus, cardiac mass, transcutaneous aspiration


Introduction: In-situ right atrial (RA) thrombus is a rare occurrence typically associated with heightened inflammatory or hypercoagulable states. Here, we present a case of in-situ RA thrombus mimicking atrial myxoma in a patient with sepsis and bacteraemia.
Case description: A 41-year-old man presented with septic arthritis and bacteraemia caused by methicillin-resistant Staphylococcus aureus (MRSA). A transoesophageal echocardiogram revealed a large pediculated mass resembling atrial myxoma, which was not visible on transthoracic echocardiography performed four days earlier. Cardiac magnetic resonance (CMR) imaging strongly suggested a thrombus, leading to the patient undergoing transcatheter aspiration. Subsequent pathology confirmed an organised fibrin thrombus without evidence of infection.
Discussion: The patient’s in-situ RA thrombus likely developed in response to a heightened inflammatory state associated with sepsis. Limited data exist on in-situ RA thrombi in the absence of atrial fibrillation, though some reports suggest a correlation between heightened inflammation and a hypercoagulable state.
Conclusion: CMR imaging is invaluable for characterising such masses and can aid in distinguishing a thrombus from a myxoma.



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    Published: 2024-06-28
    Issue: 2024: Vol 11 No 7 (view)

    How to cite:
    Alchalabi S, Museedi AS. Right atrial thrombus masquerading as myxoma. EJCRIM 2024;11 doi:10.12890/2024_004660.

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