{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T23:29:05Z","timestamp":1787527745311,"version":"build-2736575974"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"9-10","license":[{"start":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T00:00:00Z","timestamp":1613692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,25]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Mediastinal masses are a rare finding in the emergency department and typically present with vague chest complaints such as chest discomfort, chest pain, or dyspnea. Rarely do these tumors present with dysrhythmias, and when dysrhythmias are present, they typically arise secondary to endocrine or metabolic effects exerted by the tumor. Here we report a case of a patient who presented to the emergency department with atrial fibrillation with rapid ventricular response, concomitant with a history of recurrent palpitations that were previously aborted with self-induced vagal maneuvers. Upon further investigation, the patient had an anterior mediastinal mass, diagnosed as a thymoma, suspected to be contributing to his presenting dysrhythmia through mass effect.<\/jats:p>","DOI":"10.1093\/milmed\/usab057","type":"journal-article","created":{"date-parts":[[2021,2,21]],"date-time":"2021-02-21T00:25:00Z","timestamp":1613867100000},"page":"e1236-e1239","source":"Crossref","is-referenced-by-count":2,"title":["Anterior Mediastinal Mass Causing Intermittent Atrial Fibrillation"],"prefix":"10.1093","volume":"187","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9795-4545","authenticated-orcid":false,"given":"Adam M","family":"Spanier","sequence":"first","affiliation":[{"name":"Carl R. Darnall Army Medical Center, Emergency Medicine Residency , Fort Hood, TX 76544, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garrett R","family":"Evans","sequence":"additional","affiliation":[{"name":"Carl R. Darnall Army Medical Center, Emergency Medicine Residency , Fort Hood, TX 76544, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugh M","family":"Hiller","sequence":"additional","affiliation":[{"name":"Carl R. Darnall Army Medical Center, Emergency Medicine Residency , Fort Hood, TX 76544, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,2,19]]},"reference":[{"key":"2022082610281995100_R1","volume-title":"StatPearls","author":"Almeida","year":"2020"},{"issue":"1","key":"2022082610281995100_R2","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/s13244-012-0201-0","article-title":"A diagnostic approach to the mediastinal masses","volume":"4","author":"Juanpere","year":"2013","journal-title":"Insights Imaging"},{"issue":"2","key":"2022082610281995100_R3","first-page":"77","article-title":"A study of clinical characteristics of mediastinal mass","volume":"8","author":"Aroor","year":"2014","journal-title":"J Clin Diagn Res"},{"issue":"3","key":"2022082610281995100_R4","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1378\/chest.10-2292","article-title":"A 30-year-old woman with intermittent cough and a mass-like opacity in the right upper lobe","volume":"140","author":"Suwatanapongched","year":"2011","journal-title":"Chest"},{"issue":"5","key":"2022082610281995100_R5","doi-asserted-by":"crossref","first-page":"e104","DOI":"10.1016\/j.jtcvs.2009.03.003","article-title":"An adult man presenting with hemoptysis caused by mature teratoma with rupture into the bronchus and pericardium and complicated by Haemophilus influenzae infection","volume":"139","author":"Jothianandan","year":"2010","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"6","key":"2022082610281995100_R6","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1002\/jmri.22377","article-title":"Computed tomography and magnetic resonance imaging of mediastinal tumors","volume":"32","author":"Takahashi","year":"2010","journal-title":"J Magn Reson Imaging"},{"issue":"5","key":"2022082610281995100_R7","doi-asserted-by":"crossref","first-page":"e401","DOI":"10.1016\/j.athoracsur.2016.04.041","article-title":"Resection of a giant mediastinal teratoma","volume":"102","author":"Yendamuri","year":"2016","journal-title":"Ann Thorac Surg"},{"issue":"4","key":"2022082610281995100_R8","first-page":"107","article-title":"Gray-zone lymphoma. Examples of rare clinical manifestation","volume":"91","author":"Misyurina","year":"2019","journal-title":"Ter Arkh"},{"issue":"1","key":"2022082610281995100_R9","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/S0720-048X(97)00152-6","article-title":"Diagnostic approach to mediastinal masses","volume":"27","author":"Giron","year":"1998","journal-title":"Eur J Radiol"},{"issue":"4","key":"2022082610281995100_R10","first-page":"9","article-title":"Mediastinal widening on chest radiography caused by combined aortic valve disease and primary large B-cell lymphoma","volume":"9","author":"Tomaske","year":"2007","journal-title":"Images Paediatr Cardiol"},{"issue":"2","key":"2022082610281995100_R11","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.ejrad.2007.10.002","article-title":"Anterior mediastinal tumors: diagnostic accuracy of CT and MRI","volume":"69","author":"Tomiyama","year":"2009","journal-title":"Eur J Radiol"},{"issue":"19","key":"2022082610281995100_R12","doi-asserted-by":"crossref","first-page":"2107","DOI":"10.2169\/internalmedicine.49.3627","article-title":"Paroxysmal atrial fibrillation due to bronchogenic cyst","volume":"49","author":"Fujino","year":"2010","journal-title":"Intern Med"},{"issue":"12","key":"2022082610281995100_R13","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1111\/jocs.14356","article-title":"Atrial fibrillation as initial symptom of an intrapericardial bronchogenic cyst","volume":"34","author":"Kotoulas","year":"2019","journal-title":"J Card Surg"},{"issue":"836","key":"2022082610281995100_R14","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1136\/pgmj.71.836.369","article-title":"Covert bronchogenic cyst as a cause of life-threatening cardiopulmonary impairment","volume":"71","author":"Mather","year":"1995","journal-title":"Postgrad Med J"},{"issue":"6","key":"2022082610281995100_R15","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1097\/00000441-200606000-00010","article-title":"Bronchogenic cyst causing atrial fibrillation by impinging the right inferior pulmonary vein","volume":"331","author":"Parambil","year":"2006","journal-title":"Am J Med Sci"},{"issue":"3","key":"2022082610281995100_R16","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1136\/thx.43.3.216","article-title":"Left atrial compression by a mediastinal bronchogenic cyst presenting with paroxysmal atrial fibrillation","volume":"43","author":"Volpi","year":"1988","journal-title":"Thorax"},{"key":"2022082610281995100_R17","doi-asserted-by":"crossref","DOI":"10.1186\/1752-1947-2-292","article-title":"Esophageal cancer presenting with atrial fibrillation: a case report","volume":"2","author":"Bayraktar","year":"2008","journal-title":"J Med Case Rep"},{"issue":"1","key":"2022082610281995100_R18","doi-asserted-by":"crossref","first-page":"e35","DOI":"10.1016\/j.athoracsur.2020.05.038","article-title":"Giant intrathoracic schwannoma of the left vagus nerve presenting as atrial fibrillation","volume":"11","author":"Campisi","year":"2020","journal-title":"Ann Thorac Surg"},{"issue":"4","key":"2022082610281995100_R19","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.1016\/j.athoracsur.2014.12.055","article-title":"Metastatic ocular melanoma presenting as a heart-compressing mediastinal mass","volume":"100","author":"Kiparakis","year":"2015","journal-title":"Ann Thorac Surg"},{"key":"2022082610281995100_R20","article-title":"Rare cause of atrial fibrillation: a thymic mass","volume":"2016","author":"Vishwanathan","year":"2016","journal-title":"BMJ Case Rep"},{"issue":"4","key":"2022082610281995100_R21","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1177\/000331970205300411","article-title":"The effect of Valsalva maneuver on P wave in 12-lead surface electrocardiography in patients with paroxysmal atrial fibrillation","volume":"53","author":"Altunkeser","year":"2002","journal-title":"Angiology"},{"key":"2022082610281995100_R22","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1177\/117954761000300001","article-title":"Instantly converting atrial fibrillation into sinus rhythm by a digital rectal exam on a 29-year-old male","volume":"3","author":"Ruan","year":"2010","journal-title":"Clin Med Insights Case Rep"},{"issue":"5","key":"2022082610281995100_R23","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1136\/hrt.2008.155812","article-title":"Cardioversion of atrial fibrillation: the use of antiarrhythmic drugs","volume":"96","author":"Schilling","year":"2010","journal-title":"Heart"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/187\/9-10\/e1236\/45554779\/usab057.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/187\/9-10\/e1236\/45554779\/usab057.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T10:29:47Z","timestamp":1661509787000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/187\/9-10\/e1236\/6144824"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,19]]},"references-count":23,"journal-issue":{"issue":"9-10","published-online":{"date-parts":[[2021,2,19]]},"published-print":{"date-parts":[[2022,8,25]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usab057","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,9,1]]},"published":{"date-parts":[[2021,2,19]]}}}