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68-year-old woman with paroxysmal atrial fibrillation
  1. Eftihia Sbarouni1,
  2. Nektarios Kogerakis2,
  3. George Stavridis2
  1. 1 Department of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece
  2. 2 Department of Cardiothoracic Surgery, Onassis Cardiac Surgery Center, Athens, Greece
  1. Correspondence to Dr Eftihia Sbarouni, Department of Cardiology, Onassis Cardiac Surgery Center, Athens 17674, Greece; esbarouni{at}


We present the case of a 68-year-old woman, currently asymptomatic but with a history of paroxysmal atrial fibrillation and tachycardia–bradycardia syndrome, for which she underwent a DDD pacemaker implantation and was started on oral anticoagulants. A recent chest X-ray (figure 1), for respiratory infection, was performed and the patient was referred to our institution for evaluation. Following diagnostic procedures, the patient was successfully operated on.

Figure 1

Preoperative chest X-ray (A) and chest CT with contrast (B).

Question What is the most likely diagnosis?

  1. Mitral stenosis.

  2. Pericardial cyst.

  3. Left atrial appendage aneurysm.

  4. Left atrial myxoma.

  5. Atrial septal defect.

  • advanced cardiac imaging
  • congenital heart disease surgery

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  • Contributors All authors have contribution to the conception of the paper and the interpretation of the data.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Onassis Cardiac Surgery Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.