J Med Cases

Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc

Journal website https://www.journalmc.org

Case Report

Volume 12, Number 12, December 2021, pages 511-515

Left Atrial Myxoma Masquerading as Pulmonary Embolism on Electrocardiogram: A Case Report

Figures

Figure 1. The 12-lead EKG obtained on initial evaluation is significant for sinus tachycardia with left axis deviation. An incomplete right bundle branch is present given by the RSR’ pattern in leads V1-V2 in the setting of a QRS of 94 ms. The EKG is also significant for an S1-Q3-T3 pattern. EKG: electrocardiogram.

Figure 2. Computed tomography scan of the chest is significant for a filling defect within the left atrium that measures approximately 3.6 × 1.6 cm.

Figure 3. Serial images obtained by a transthoracic echocardiogram. (a) The size of the affixed mass measuring 1.6 × 3.4 cm. (b) The mass is affixed to the mitral valve (blue arrow) as seen on M-mode. (c) No other filling defects in the left ventricle aside from the previously described mass. (d) The extent of outflow tract obstruction.

Table

**Table 1.** Laboratory Workup
Laboratory test	Result value	Reference range
White blood cells	7.2	4.5 - 11.0 × 10³/µL
Hemoglobin	15.1	12.0 - 16.0 g/dL
Hematocrit	44	35.0-48.0%
Mean corpuscular volume	87.5	80.0 - 100.0 fL
Platelet count	320	140 - 450 × 10³/µL
Sodium	140	136 - 145 mmol/L
Potassium	4	3.5 - 5.2 mmol/L
Chloride	106	96 - 110 mmol/L
Glucose	123 (H)	70 - 99 mg/dL
Blood urea nitrogen	6	5 - 25 mg/dL
Albumin	4.1	3.5 - 5.0 g/dL
Total bilirubin	0.6	0.2 - 1.3 mg/dL
Calcium	9.6	8.5 - 10.5 mg/dL
Creatinine	0.57	0.44 - 1.00 mg/dL
Alkaline phosphatase	110	38 - 126 U/L
Total protein	6.7	6.0 - 8.0 g/dL
Aspartate aminotransferase	25	10 - 42 U/L
Anion gap ratio	1.6	> 1.0
Carbon dioxide	26	24 - 31 mmol/L
Anion gap	8	5 - 13 mmol/L
Alanine aminotransferase	20	10 - 60 U/L
Glomerular filtration rate	> 60	> 60 mL/min/1.73 m²
Troponin I	0.04 (H)	< 0.04 ng/mL