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68-year-old woman with paroxysmal atrial fibrillation


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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