A 67-Year-Old Man With a Mass Shadow in His Heart Chamber During Coronary Angiography

J INVASIVE CARDIOL 2020;32(4):E100.

Key words: cardiac imaging, hypertrophic cardiomyopathy, intramyocardial calcification

A 67-year-old man was admitted to our hospital due to chest tightness induced by activity that had started about 2 months earlier. Electrocardiography revealed left ventricular hypertrophy with negative T-waves in leads I, II, aVL, aVF, and V2 to V6. His troponin and N-terminal pro-brain natriuretic peptide levels were normal. Coronary angiography showed 70% stenosis of the proximal left anterior descending coronary artery. However, there was a mass shadow on the apex of the left ventricle, the position of which was fixed; there was no abnormal swing in the contraction of the heart chamber (Figure 1 and Video 1). Possible underlying etiologies included pericarditis, myocarditis, and intracardiac tumor in the left ventricle or metastatic adenocarcinoma; therefore, we performed cardiac magnetic resonance imaging, which resulted in a diagnosis of ventricular apical hypertrophic cardiomyopathy with intramyocardial calcification (Figure 1). Intramyocardial calcification can exist only in the heart chamber, with no calcification in other parts. 

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From ¹the Department of Cardiology, YangXin Hospital of Traditional Chinese Medicine, Shandong Province, China; and ²the Department of Cardiology, Jiading District Central Hospital Affiliated Shanghai University of Medical Health Sciences, Shanghai, China.

Disclosure: The authors have completed and returned the ICMJE Form for Disclosure of Potential Conflicts of Interest. The authors report no conflicts of interest regarding the content herein. 

The authors report that patient consent was provided for publication of the images used herein.

Manuscript accepted May 30, 2019.

Address for correspondence: Dr Yangyi Lin, Department of Cardiology, Jiading District Central Hospital Affiliated Shanghai University of Medical and Health Sciences, Shanghai, 200018, China. Email: dr.linyangyi@outlook.com