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Mobile mass in the left atrium with a peculiar auscultation
  1. Miguel Angel Lopez-Lizarraga,
  2. Alejandro Ezquerra-Osorio,
  3. Roberto Perez-Lopez
  1. Cardiology, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Mexico
  1. Correspondence to Dr Miguel Angel Lopez-Lizarraga, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Mexico; drlopezlizarraga{at}

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Clinical introduction

A woman in her 60s presented to her cardiologist with a history of dyspnoea, fatigue and peripheral oedema.

On physical examination, blood pressure was 95/60 mm Hg, heart rate 88 beats/min, respiratory rate 20 per minute, and room air oxygen saturation 90%.

Auscultation in left lateral decubitus of the apex revealed S1 with splitting. Clear systole, S2 was accompanied by a mitral opening snap with early diastolic rumble that ended with a presystolic murmur. These findings were modified by changes in position.

It was decided to perform an echocardiogram that revealed a mobile mass in the left atrium dependent on the interatrial septum, which moved towards the cavity of the …

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  • Contributors All authors have contributed significantly to the conception, design, writing and review of this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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