Hyperechogenic Mass in the Right Ventricle - Facts and Dilemmas

This paper presents a 61-year-old patient who presented to her cardiologist complaining of intolerance to exercise and progressive dyspnea. Her past medical history is remarkable for arterial hypertension and heart rhythm disorders, for which she was treated at a young age, and dilatation of the right cavities which has been monitored by ultrasound since 2006. TTE and TEE revealed a hyperechogenic mobile mass in the dilated and hypokinetic right ventricle was found. Other findings included homozygotic mutation at PAI-5G polymorphism whereas cardiac MRI revealed pathological structure of the wall of the right ventricle as well as a penduculated tumour in its cavity. The hyperechogenic mass was surgically removed and the results of pathological examination revealed thrombi in the right ventricle. Conclusion: Based on the result, the three probable causes of development of thrombi were: hereditary thrombophilia, arrythmogenic RV dysplasia or a combination of both conditions.