Rare finding using transthoracic echocardiography leading to a prognostically important diagnosis

Background: We report about a very interesting and none common finding observed using transthoracic echocardiography (TTE). A patient with new documented symptomatic atrial fibrillation (AF) who was admitted to our clinic for further clarification and stabilization received a routine TTE and transesophageal echocardiography (TEE) as a step before electrical cardioversion. The TTE revealed an extracardiac structure compressing the left atrium (LA), which was not observed on the TEE. For further clarification, the patient received a computer tomography of the chest which revealed an esophageal carcinoma. No specific symptoms of the disease were reported from the patient before this admission. Conclusion: TTE is the most commonly performed cardiac investigation. It provides generally very valuable information about cardiac structure and function. Our case shows the role of this method in identifying extra cardiac formation leading to important diagnosis.