From the Departments of Radiology (J.d.M.C., L.F.A.d.H., L.G.d.S., E.C.P., P.F.R.), Internal Medicine (J.C.C.), Pathology (S.N.L.), and Cardiology (J.C.P.F.), Hospital del Henares-Unidad Central de Radiodiagnóstico, c/Marie Curie s/n, 28822 Coslada, Spain.
Jaime de Miguel Criado, MD Luis F. Aguilera del Hoyo, MD Laura García del Salto, MD Eva Cueva Pérez, MD Jesús Casado Cerrada, MD Santiago Nieto Llanos, MD José Carlos Porro Fernández, MD Patricia Fraga Rivas, MD
A 61-year-old man with no relevant medical history was admitted to the emergency department with symptoms of congestive heart failure and a 1-week history of chest pain, progressive dyspnea, abdominal swelling, bipedal edema, and anorexia.
Laboratory test results, including complete blood count and electrolyte, creatinine, creatine phosphokinase, and troponin T levels were normal. Electrocardiographic findings were unremarkable.
Initial chest radiography showed an enlarged heart with bilateral pleural effusion.
Transthoracic echocardiography revealed an irregular right atrial mass and moderate to severe pericardial effusion.
The patient subsequently underwent computed tomography (CT) of the chest, abdomen, and pelvis followed by cardiac magnetic resonance (MR) imaging for further evaluation of the atrial mass. Because of the suspected diagnosis, conventional radiography of the skeleton was performed.