Heart Leiomyoma Extending from the Inferior Vena Cava to the Right Heart

60-year-old woman, with a historyof hysterectomy for leiomyomatwo years earlier, was admitted toour department because of deterioratingfatigue and dyspnoea on exertion, pedaloedema, and a recent episode of syncope.Physical examination revealed an early di-astolic plop associated with a rumblingmurmur in the left parasternal region, he-patomegaly, ascites and severe oedema ofthe lower extremities. Transthoracic echocardiography re-vealed mild right ventricular dilatationwith preserved systolic function (S-wavevelocity measured with pulsed tissue Dop-pler in the basal free wall of the right ven-tricle >13 cm/s). In addition, a mass ofmoderate echogenicity was identified in-side the right ventricle in the long left pa-rasternal view (Figure 1A, arrow), as wellas in a modified apical 4-chamber view(Figure 1B, arrow). Partial obliteration ofthe flow of the inferior