多模态心脏成像是对右房肿块（肿瘤、炎症或血栓）进行无创评估的有价值工具。我们报告了一例在对心力衰竭/左室射血分数降低和双心房起搏器进行评估时，发现了一个右心房肿块（通过经胸心脏超声和经食管心脏超声）。经胸超声和经食管超声发现右房底层的大型低回声活动性肿块，伸展自上腔静脉，并有起搏器装置导线附着。排除了感染性心内膜炎（没有全身感染症状；血培养阴性）。胸部CT血管成像显示一前纵隔肿块，高度可疑为恶性肿瘤，包绕左锁骨下静脉。患者选择不进行前纵隔肿块的侵入性评估。抗凝治疗的作用尚不清楚。计算机断层扫描补充了心脏超声评估和管理由前纵隔肿块引起的右心房移动性回声异常。版权©南达科他州医学协会。

Multimodality cardiac imaging is a valuable tool for the noninvasive evaluation of right atrial masses (tumor, vegetation, or thrombus).We report a case of right atrial mass that was discovered on a transthoracic echocardiogram ordered for pacemaker-pocket erythema in a 101-year-old man with heart failure/reduced left-ventricular ejection fraction and a dual-chamber pacemaker. Transthoracic and transesophageal echocardiogram showed a large hypoechoic mobile RA mass extending from the superior vena cava, with pacemaker device lead attachment. Infective endocarditis was excluded (no symptoms of systemic infection; negative blood cultures). CT angiography of the chest revealed an anterior mediastinal mass, highly suspicious for malignancy, encasing the left subclavian vein. The patient chose not to pursue invasive assessment of the mediastinal mass. Role of anticoagulation is unclear.Computed tomography complemented echocardiographic assessment and management of a right atrial mobile echo density due to a large anterior mediastinal mass.Copyright© South Dakota State Medical Association.