A diagnostic odyssey: detection of an unusual anterior papillary muscle of the tricuspid valve

Eur J Echocardiogr. 2010 Jun;11(5):E19. doi: 10.1093/ejechocard/jep225. Epub 2010 Jan 6.

Abstract

A routine chest X-ray in a 78-year-old female patient suggested a retained vascular catheter in the right ventricle (RV). On transthoracic echocardiography, a prominent linear echo was found in the RV and the patient was referred for cardiac computed tomography and magnetic resonance imaging. Although neither of these tests showed evidence of a retained foreign body in the RV, they could not clarify the nature of the linear structure within the RV cavity. Finally, transesophageal echocardiography, using a matrix array three-dimensional probe solved the mystery: the linear structure in question within the RV was a large papillary muscle with attachments to the anterior leaflet of the tricuspid valve and an unusual origin from the interventricular septum.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Echocardiography
  • Echocardiography, Transesophageal
  • Female
  • Foreign Bodies / diagnostic imaging
  • Foreign Bodies / surgery*
  • Heart Septal Defects, Atrial / diagnostic imaging
  • Heart Septal Defects, Atrial / pathology*
  • Heart Septum / diagnostic imaging
  • Heart Septum / pathology*
  • Heart Ventricles / abnormalities*
  • Heart Ventricles / diagnostic imaging
  • Humans
  • Magnetic Resonance Imaging
  • Papillary Muscles / abnormalities*
  • Papillary Muscles / diagnostic imaging
  • Tricuspid Valve / abnormalities*
  • Tricuspid Valve / diagnostic imaging