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The British Journal
of Cardiology

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The value of echocardiography in atrial fibrillation

September 2009 Volume 16, Issue 5 Br J Cardiol 2009;16:241

Authors:
Peadar McKeown, Kerri Toland, Ian B A Menown

Peadar McKeown
Staff Grade

Kerri Toland
Senior House Officer Haematology, Craigavon Area Hospital

Ian B A Menown
Consultant Cardiologist

Craigavon Cardiac Centre, Craigavon, Northern Ireland, BT63 5QQ

Correspondence to:
Dr I B A Menown
ian.menown@southerntrust.hscni.net

A 29-year-old man was admitted with new onset atrial fibrillation (figure 1).

Figure 1. Electrocardiogram (ECG) showing new-onset atrial fibrillation

Figure 3. Cardiac magnetic resonance image (MRI) consistent with a lymphoma tumour

Figure 2. Echocardiography showing large intra-atrial mass

One year previously he had been treated with six cycles of chemotherapy for aplastic large cell lymphoma. He had a pyrexia (38.5oC), elevated C-reactive protein (14.6 mg/L) and low haemoglobin (10.8 g/dL). As part of a screen for infection, echocardiography was performed to exclude endocarditis (figure 2), but revealed a large intra-atrial mass. Cardiac magnetic resonance imaging (MRI) (figure 3) appearance was consistent with a lymphoma tumour. Fine-needle aspiration of an enlarged supra-clavicular node showed evidence of relapsed lymphoma. Further treatment with chemotherapy resulted in complete resolution (figure 4) of the intra-atrial mass, of his symptoms, and in restoration of sinus rhythm.