PT  - JOURNAL ARTICLE
AU  - Galas, Anna
AU  - Hryniewiecki, Tomasz
AU  - Szymanski, Piotr
TI  - An 82-year-old woman with a cardiac mass
AID  - 10.1136/heartjnl-2015-308617
DP  - 2016 Jun 01
TA  - Heart
PG  - 881--881
VI  - 102
IP  - 11
4099  - http://heart.bmj.com/content/102/11/881.short
4100  - http://heart.bmj.com/content/102/11/881.full
SO  - Heart2016 Jun 01; 102
AB  - Clinical introduction An 82-year-old woman suspected of a cardiac tumour was referred for evaluation. Patient's medical history included atrial fibrillation, implantation of a VVI (ventricular stimulation) pacemaker 3 years earlier due to advanced atrioventicular (AV) block, arterial hypertension and hypothyroidism. Patient was adequately anticoagulated with warfarin (international normalized ratio (INR) 3.0 at admission). She reported occasional palpitations and a 2 kg weight loss in the last 2 years, but denied shortness of breath, chest pain, malaise, fever, chills or cough. Blood samples were taken for tests and cultures. Red blood cells, haemoglobin, white blood cells, platelets, C- reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were within normal ranges. Blood cultures were negative. Echocardiogram (figure 1A) (see online supplementary videos 1 and 2) and cardiac CT were performed (figure 1B).Question Which of the following is the most likely diagnosis?Caseous calcification of the mitral annulusCoconut left atriumMitral valve myxomaPeriannular abscessQuestion