Clinical utility of transthoracic echocardiography in assessing frequency and pattern of atrial masses among patients with cardiac diseases

Abstract

Background: Echocardiography plays a fundamental role in the evaluation of patients with atrial masses. The ability to distinguish tissue characteristics such as location, attachment, shape, size, and mobility noninvasively, quickly, cheaply, and without the use of ionizing radiation makes echocardiography the ideal diagnostic modality. With careful attention to mass location and morphology and appropriate application of clinical information, echocardiography can usually distinguish between the three principal atrial masses as follows: tumor, thrombus, and vegetation. Although transesophageal echocardiography has better sensitivity and specificity for detecting atrial masses, transthoracic echocardiography (TTE) can also detect atrial masses with specificity and sensitivity of about 58% and 98%, respectively. Objectives: The study is aimed at assessing the frequency and patterns of atrial masses in an urban teaching hospital using TTE. Materials and Methods: A retrospective review of our echocardiogram reports from July 2009 to June 2014 was done to identify the frequency of atrial masses, gender distribution, sizes, clinical presentations, and locations. Results: A total of 1027 echo examinations were done over this period, comprising 503 males (48.98%) and 524 females (51.02%). Nonvegetative atrial masses were found in six of these patients representing 0.58% of the study population. Myxoma was the most common mass noted, 3 out of 4 were found in female, and all were found in the left atrium. The two atrial thrombi were detected in the right atrium and both were found in males. Conclusion: Atrial masses are not rare and TTE is still valuable in the diagnosis and initial characterization of atrial masses.