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Tuberculoma invading the right atrium in an old patient
Tuberculoma invading the right atrium in an old patient
Mustafa Sağlam, Osman Karakaya, Hekim Karapınar, İrfan Barutçu, Cihangir Kaymaz
Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi Kardiyoloji Kliniği, İstanbul
Tuberculoma is a rare condition which is considered in the
differential diagnosis of intracardiac masses. A 74-year-old
woman presented with complaints of dyspnea and epigastric
pain. She had a history of pulmonary tuberculosis treated
35 years before and VVIR permanent pacemaker implantation
for severe atrioventricular block six months before.
Transthoracic and transesophageal echocardiography showed
a right atrial mass suggestive of thrombus and anticoagulant
therapy was instituted. However, echocardiographic findings
persisted on the eighth day of anticoagulation and the mass
filling the right atrium was removed surgically. Pathologic
examination of the surgical specimen showed caseous
necrosis and the patient was administered antituberculous
treatment with four drugs. She was discharged two weeks
postoperatively, but was hospitalized again because of deterioration
of her general status and respiratory insufficiency,
requiring intubation and ventilation. She died on the fifth
day of intubation from septic shock.
Keywords : Echocardiography; heart atria; tuberculoma/diagnosis; tuberculosis, cardiovascular.
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