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Image challenge
Abnormal echocardiographic finding mimicking paracardiac cystic lesion
  1. Qianying Yang1,2,
  2. Yang Bai1,2,
  3. Chunyan Ma1,2
  1. 1 Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, Liaoning, China
  2. 2 Clinical Medical Research Center of Imaging in Liaoning Province, Shenyang, Liaoning, China
  1. Correspondence to Dr Chunyan Ma, Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, Liaoning, China; cmu1h_mcy{at}126.com; Mrs Yang Bai; baiyangfriend1984{at}163.com

https://doi.org/10.1136/heartjnl-2024-324473

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    Clinical introduction

    The patient was a man in his 40s with a medical history of hypertension, Behcet’s disease (BD) and chronic renal dysfunction. Previous medical interventions included a spectrum of procedures, including catheter-directed thrombectomy for popliteal artery aneurysms with thrombosis, vascular bypass grafting for cerebral-anterior communicating artery aneurysms and arch replacement and stent implantation for aortic dissecting aneurysms. The patient was receiving therapeutic doses of the following medications: sacubitril valsartan sodium tablets, prednisone acetate, cyclophosphamide and azathioprine. He had no medical history of myocardial infarction (MI). He was admitted to our hospital with issues of chest pain, shortness of breath and heart palpitations without any obvious inducement. A 12-lead ECG indicated sinus rhythm with a heart rate of 78 bpm. Conventional transthoracic echocardiography observed paracardiac cystic lesions adjacent to the atrioventricular sulcus (figure 1A–C, online supplemental video 1).

    Supplementary video

    [heartjnl-2024-324473supp001.mov]
    Figure 1

    Transthoracic …

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    Footnotes

    • Contributors All authors fully contributed to the conception, drafting and editing of the 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.

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

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.