This Article Full Text Full Text (PDF) Data Supplement Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Goldbarg, S. Articles by Sharma, S. Search for Related Content PubMed PubMed Citation Articles by Goldbarg, S. Articles by Sharma, S. Related Collections Catheter-based coronary and valvular interventions: other CV surgery: aortic and vascular disease Angiography Computerized tomography and Magnetic Resonance Imaging

(Circulation. 2007;115:e47-e48.)
© 2007 American Heart Association, Inc.

Images in Cardiovascular Medicine

Cardiac Leiomyosarcoma

Seth Goldbarg, MD; Naveenta Kumar, BA; Samin Sharma, MD

From the Mount Sinai School of Medicine, Cardiovascular Institute, New York, NY.

Correspondence to Seth Goldbarg, MD, The Mt. Sinai School of Medicine, Cardiovascular Institute, One Gustave L. Levy Place, New York, NY 10029-6574. E-mail goldbash@post.harvard.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

A 58-year-old woman was admitted to an outside hospital after an episode of syncope. She reported a 4-month history of progressively worsening dyspnea on exertion. There was no other significant medical history. Her blood pressure was 145/76 mm Hg, heart rate was 80 bpm, and oxygen saturation was 97% on room air. Cardiovascular examination revealed a grade III ejection systolic murmur, which could be heard loudest in the second intercostal space at the left sternal border. The ECG was notable for right ventricular hypertrophy. An echocardiogram revealed pulmonary stenosis with marked right ventricular hypertrophy and moderate tricuspid regurgitation. The patient was transferred to our institution for pulmonary valvuloplasty.

On right heart catheterization, a large filling defect was visualized in the right ventricular outflow tract (Figure 1 and Movie I), with a markedly elevated right ventricular pressure of 129/16 mm Hg and a significant pressure gradient across the right ventricular outflow tract (>100 mm Hg). Transthoracic echocardiogram with Doppler imaging confirmed the presence of a mass, which caused a significant obstruction to flow in the right ventricular outflow tract (Movie II). Cardiac magnetic resonance imaging with gadolinium contrast revealed a 4x2-cm sessile vascularized mass originating in the right ventricular outflow tract that involved the pulmonary valve and extended to the pulmonary artery bifurcation (Figure 2).

View larger version (153K):   Figure 1. Right ventricular angiography reveals a filling defect in the proximal pulmonary artery, nearly obliterating the outflow tract.

View larger version (147K):   Figure 2. Cardiac magnetic resonance imaging confirmed the presence of a large, . . . [Full Text of this Article]