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A rare case of unexpected cardiac incidentaloma causing syncope

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EDIMES Edizioni Internazionali Srl
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225 proceedings in Intensive Care Cardiovascular Anesthesia Endorsed by proceedings HSR Proceedings in Intensive Care and Cardiovascular Anesthesia 2010, Vol. 2 IMAGES IN MEDICINE Corresponding author: Antonio Grimaldi, MD Deparment of Cardiothoracic and Vascular Istituto Scientifico San Raffaele Via Olgettina, 60 - 20132 Milano, Italy e.mail: [email protected] A 68-year-old woman presented with re- current paroxistic tachycardia followed by syncope occurring in right lateral decubi- tus. A transthoracic echocardiogram showed a cardiac mass close to the right atrium (Figure 1, yellow arrows) and to the inferior vena cava, apparently not interfering with diastolic filling. A transesophageal study showed a right para-atrial mass close to the atrioventricu- lar groove but not infiltrating the cardiac wall (Figure 2, Panel A, yellow arrows) with regular surface and solid texture. A contrast enhancement computed tomog- raphy scan confirmed the anatomical de- tails (Figure 2, Panel B, yellow arrows) and the relationship with the right coronary artery (Figure 2, Panel B, red arrows). In the hypothesis that the compression of the inferior vena cava was responsible for the syncope in the right lateral decubitus, the patient underwent a surgical interven- tion without cardiopulmonary bypass. Intraoperatively, high doses of alpha and A rare case of unexpected cardiac incidentaloma causing syncope E. Collu1, A. Grimaldi1, S. Benussi1, A. Castiglioni1, E. Bignami1, N. Rizzo2, M. De Bonis1, G. Melisurgo1, G. La Canna1, O. Alfieri1 1Department of Cardiothoracic Surgery and ¬≤Pathology, Universit√† Vita-Salute San Raffaele, Milan, Italy Keywords: paraganglioma, cathecolamines, tachycardia, syncope. Figure 1 - A standard transthoracic echocardio- gram from the subcostal approach shows a cardiac mass close to the right atrium (yellow arrows). beta blockers were used to manage hyper- tensive crisis up to 220/110 mmHg. The tumour was successfully removed and appe

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