case_images: PMC11195027_01
case_images: Electrocardiogram demonstrating irregularly irregular intervals, without any p waves suggestive of atrial fibrillation.
case_images: acc-11-02-10285-g001.jpg
case_images: PMC11195027_01_acc-11-02-10285-g001.jpg
case_images: f1
case_images: Upon further evaluation, the patient was found to have new-onset AF (Figure 1).
case_images: Transesophageal echo demonstrating stalk-like lesion in the left atrial appendage.
case_images: acc-11-02-10285-g002.jpg
case_images: PMC11195027_01_acc-11-02-10285-g002.jpg
case_images: f2
case_images: Subsequently, a transesophageal echocardiogram (TEE) and electrical cardioversion were organized, with the TEE revealing a ~1.0 x 1.0 cm stalk-like echo density visualized in LAA with attachment to the coumadin ridge (Figure 2).
case_images: Cardiac magnetic resonance imaging of the stalk-like lesion, measuring 5 mm x 9 mm.
case_images: acc-11-02-10285-g003.jpg
case_images: PMC11195027_01_acc-11-02-10285-g003.jpg
case_images: f3
case_images: Cardiac magnetic resonance (CMR) imaging was pursued to better characterize the mass, which revealed a 5 x 9 mm mass in the left atrial appendage with low signal on all sequences and no detectable contrast uptake (Figure 3).
case_images: Cardiac computed tomography demonstrating an interval decrease in the lesion, measuring 5 mm x 6 mm.
case_images: acc-11-02-10285-g004.jpg
case_images: PMC11195027_01_acc-11-02-10285-g004.jpg
case_images: f4
case_images: The decision was made to pursue anticoagulation for six weeks, with the subsequent cardiac computed tomography (CT) revealing an interval decrease in the size of the non-calcified mass, measuring 6 x 5 mm (Figure 4).