Three’s Company: Cardiac myxoma, bicuspid aortic valve with severe aortic stenosis and ascending thoracic aortic aneurysm uncovered by anaplasmosis infection

Figures

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  Fig. 1. A: CT chest left ventricular long axis view showing an intracardiac mass-like filling defect extending across the mitral valve (red arrow). B: CT chest four chamber view of heart showing cardiac mass (red arrow), its close approximation to the interatrial septum and extension across the mitral valve. C: Four chamber apical view of transthoracic echo showing the left atrial mass prolapsing through mitral valve (red arrow).

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  Fig. 2. A: Short access view in TEE showing a bicuspid aortic valve with thickened and calcified leaflets. B: TEE of the ascending thoracic aorta showing the 5.6 cm aneurysmal dilatation.

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  Fig. 3. A: Mid-esophageal four chamber view in TEE showing the cardiac myxoma originating from left atrial septum and prolapsing through mitral valve. B: Bicaval view in TEE showing cardiac myxoma in left atrium attached to interatrial septum. C: 3-D image in TEE showing the cardiac myxoma.

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  Fig. 4. A: Gross specimen of cardiac myxoma after extraction showing a red-brown polypoid gelatinous mass. B: Gross specimen of bicuspid aortic valve showing thickened leaflets.