{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:04:26Z","timestamp":1792785866330,"version":"4.5.0"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Scientific Research Program of Wuhan Municipal Health Commission","award":["WX21D58"],"award-info":[{"award-number":["WX21D58"]}],"id":[{"id":"https:\/\/ror.org\/04jjn5s14","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mobile echoic structures in the fossa ovalis region represent a common diagnostic pitfall in patients with atrial septal defect (ASD). Misdiagnosis as pathological masses may lead to unnecessary invasive interventions. This case demonstrates the value of a stepwise multimodal imaging strategy for differential diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>A 48-year-old female presented with intermittent chest discomfort and was initially diagnosed with suspected patent foramen ovale (PFO) at a referring hospital. After systematic evaluation at our centre, the diagnosis was revised to secundum ASD (fossa ovalis type) accompanied by a mobile linear hyperechoic structure at the defect margin. The patient underwent transoesophageal echocardiography (TEE), transthoracic contrast echocardiography, and contrast-enhanced cardiac computed tomography, with complete laboratory workup to exclude infectious and thrombotic aetiologies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>High-resolution TEE confirmed a true anatomical septal defect rather than a PFO flap channel. Multimodal imaging stepwise excluded pathological mimics, including infective vegetation, mural thrombus, and cystic haemangioma, and the lesion was finally identified as benign residual fragments of the primary septum. Accurate differentiation directly guided clinical decision-making and avoided unnecessary invasive intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag701","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T19:22:37Z","timestamp":1789672957000},"source":"Crossref","is-referenced-by-count":0,"title":["Multimodal imaging in discriminating atrial septal defect combined with mobile echoic strands in fossa ovalis: a case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4034-7144","authenticated-orcid":false,"given":"Yi","family":"Cheng","sequence":"first","affiliation":[{"name":"Department of Ultrasound, Wuhan Asia General Hospital, School of Medicine, Wuhan University of Science and Technology , Wuhan 430056 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1333-7752","authenticated-orcid":false,"given":"Jing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Wuhan Asia General Hospital, School of Medicine, Wuhan University of Science and Technology , Wuhan 430056 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9400-9062","authenticated-orcid":false,"given":"Xiaojing","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Wuhan Asia General Hospital, School of Medicine, Wuhan University of Science and Technology , Wuhan 430056 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"2026101616265996400_ytag701-B1","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1016\/j.echo.2015.05.015","article-title":"Guidelines for the echocardiographic assessment of atrial septal defect and patent foramen ovale: from the American Society of Echocardiography and Society for Cardiac Angiography and Interventions","volume":"28","author":"Silvestry","year":"2015","journal-title":"J Am Soc Echocardiogr"},{"key":"2026101616265996400_ytag701-B2","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1136\/heart.88.1.104","article-title":"Development and structure of the atrial septum","volume":"88","author":"Anderson","year":"2002","journal-title":"Heart"},{"key":"2026101616265996400_ytag701-B3","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S0025-6196(12)60336-X","article-title":"Incidence and size of patent foramen ovale during the first 10 decades of life: an autopsy study of 965 normal hearts","volume":"59","author":"Hagen","year":"1984","journal-title":"Mayo Clin Proc"},{"key":"2026101616265996400_ytag701-B4","doi-asserted-by":"crossref","first-page":"1921","DOI":"10.1016\/S0140-6736(13)62145-5","article-title":"Atrial septal defects","volume":"383","author":"Geva","year":"2014","journal-title":"Lancet"},{"key":"2026101616265996400_ytag701-B5","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1007\/s00270-010-0062-1","article-title":"Hemangioma of the interatrial septum: CT and MRI features","volume":"34 Suppl 2","author":"Hrabak-Paar","year":"2011","journal-title":"Cardiovasc Intervent Radiol"},{"key":"2026101616265996400_ytag701-B6","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.jacc.2018.05.026","article-title":"Neoplasia and the heart: pathological review of effects with clinical and radiological correlation","volume":"72","author":"Maleszewski","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2026101616265996400_ytag701-B7","doi-asserted-by":"crossref","first-page":"3075","DOI":"10.1093\/eurheartj\/ehv319","article-title":"2015 ESC guidelines for the management of infective endocarditis: the task force for the management of infective endocarditis of the European Society of Cardiology (ESC). 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