Left atrial rhabdomyosarcoma diagnosed by Emergency Department point-of-care echocardiography

Am J Emerg Med. 2018 Oct;36(10):1923.e5-1923.e7. doi: 10.1016/j.ajem.2018.06.042. Epub 2018 Jun 21.

Abstract

Background: We present a case of intracardiac rhabdomyosarcoma associated with cardiopulmonary instability which was diagnosed by emergency providers using point-of-care echocardiography.

Case report: A previously healthy 49-year-old man presented to the Emergency Department with progressive dyspnea and hypotension. Emergency providers identified a left atrial mass using point-of-care ultrasound. Expedited advanced imaging and surgical management showed a malignant cardiac rhabdomyosarcoma. Why should an emergency physician be aware of this? This case report highlights the utility of point-of-care ultrasound in the work-up of patients with undifferentiated dyspnea and hypotension, even in cases of rare diagnoses. Early diagnosis and management of both benign and malignant intracardiac tumors is essential to preoperative planning and patient prognosis. Ultrasound findings consistent with intracardiac masses should be recognized and used to guide further consultation, advanced imaging, and treatment.

Publication types

  • Case Reports

MeSH terms

  • Cardiac Surgical Procedures
  • Dyspnea / diagnostic imaging
  • Dyspnea / etiology
  • Echocardiography*
  • Emergency Service, Hospital
  • Heart Atria / pathology*
  • Heart Atria / surgery
  • Heart Neoplasms / diagnostic imaging*
  • Heart Neoplasms / pathology
  • Heart Neoplasms / surgery
  • Humans
  • Hypotension / diagnostic imaging
  • Hypotension / etiology
  • Male
  • Middle Aged
  • Point-of-Care Systems*
  • Rhabdomyosarcoma / diagnostic imaging*
  • Rhabdomyosarcoma / pathology
  • Rhabdomyosarcoma / surgery
  • Treatment Outcome
  • Ultrasonography