Presentation
A 52-year-old woman with a background of alpha-1-antitrypsin deficiency and severe emphysema underwent transthoracic echocardiography (TTE) that demonstrated an apparent right atrial mass adhering to the inter-atrial septum. She was referred for transoesophageal echo (TOE) to investigate further. Additionally, she had been noted to desaturate on exercise, raising the possibility of intra-cardiac shunting. She was thus also referred for saline-bubble contrast TTE.
Figure 1. Transthoracic echocardiography immediately following transoesophogeal echocardiogram. Apical four-chamber view at end-diastole demonstrating normal left ventri
