Cardiac Varix in Relation to Right Atrial Free Wall Presenting as a Mass Compressing the Right Atrium and Mimicking a Pericardial Cyst

ArticleinThe Annals of thoracic surgery 78(6):e96-7 · January 2005with19 Reads
DOI: 10.1016/j.athoracsur.2003.12.070 · Source: PubMed
Abstract
Cardiac varix is a rare entity. It is generally small and is in relation to the interatrial septum, often mistaken as cardiac myxoma. A 19-year-old girl, on evaluation of respiratory infection, was found to have a mass compressing the right atrium. Computed tomographic scan and magnetic resonance imaging suggested a differential diagnosis of pericardial cyst or hydatid cyst. Peroperatively, a large (8 x 6.5 x 5.5 cm) cystic lesion in relation to the right atrial free wall was found. The histopathology of the resected mass revealed it to be a cardiac varix. The case is notable for its large size and its location in relation to the right atrial free wall.
    • However, even more infrequent are the number of case reports. In fact, only nine cases in living patients have been reported up to date2345678910. The low recognition of the disease and the fact they rarely grow large enough to develop symptoms may account for the difference between its incidence in autopsied heart and case reports. Differential diagnosis is quite challenging.
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    • They are situated in the lower part of the interatrial septum and rarely exceed 20 mm in diameter. However, in this case, a large cardiac varix (80 × 65 × 55 mm) was found in relation to the right atrial free wall, presenting as a mass compressing the right atrium [5]. Rasmussen et al. [6] reported that a cardiac varix supplied by atrial branches of both the right and left coronary arteries made it more likely that the lesion was an arteriovenous malformation rather than a venous varicosity.
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