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European Journal of Echocardiography 2008 9(1):133-135; doi:10.1016/j.euje.2007.04.012
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2007. For permissions please email: journals.permissions@oxfordjournals.org

A case of pulmonary vein obstruction: evaluation using newer echocardiographic imaging techniques

Ignatios Ikonomidis*, Maria Nikolaou, Ioannis Paraskevaidis, John Lekakis and Dimitrios Th. Kremastinos

2nd Department of Cardiology, Athens University, Attikon Hospital, Perikleous Street 19, N. Chalkidona, Athens, 14343, Greece

Received 31 March 2007; accepted after revision 15 April 2007; online publish-ahead-of-print 31 July 2007.

* Corresponding author. Tel: +30 6944805732; fax: +30 210 5832351. E-mail address: ignoik{at}otenet.gr


  Abstract

A 59-year-old woman was admitted in our hospital due to persistent cough and dyspnea. Transthoracic 2-dimensional echocardiography demonstrated a cardiac mass (29x34 mm) that extended from the right upper pulmonary vein into the left atrium causing the partial obstruction of the right lower vein as indicated by the increased Doppler velocities. Contrast echocardiography confirmed the presence of microcirculation within the mass. During transesophageal (TEE) echocardiographic study, color Doppler imaging and power Doppler imaging (Angio® Vivid 7, GE Medical System, Horten, Norway) demonstrated the presence of vascular flow within the mass. A chest magnetic resonance tomography showed a pulmonary mass of 30x25x28 mm infiltrating the pulmonary veins. After surgery, biopsy confirmed a high grade mucoepidermoid lung cancer with few large arterioles. The new echocardiographic techniques can reliably differentiate a cardiac tumor from a cardiac thrombus.

Keywords: Contrast; Color Doppler; Pulmonary vein; Cardiac mass; Left atrium; Mucoepidermoid lung cancer


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