Intracardiac Mass Of Atypical Location In Septic Patient

The case is presented of a young male from China admitted to the ICU due to a septic shock of respiratory origin. Abscesses at different levels were present, mainly in the lung, and the echocardiogram showed a large multilobulated mass in the right atrium, apparently originated from the Eustachian valve. The initial management of the patient was conservative with antibiotic and anticoagulant treatment, but due to the lack of response and the presence of new embolic necrotising events, surgery was proposed.Intracardiac masses at this level are infrequent, and the initial therapeutic approach is controversial. Clinical presentation, along with the imaging study, can help in suggesting the most probable origin, but the histopathological study of the specimen provides the final diagnosis, with thrombi being the most frequent cause of intracardiac mass. Anticoagulation is usually the initial therapeutic approach, but if there is no effective response, open surgery is an adequate and safe diagnostic and therapeutic option. (C) 2017 Sociedad Espanola de Cirugia Toracica-Cardiovascular. Published by Elsevier Espana, S.L.U.