{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T08:23:41Z","timestamp":1759134221506,"version":"3.44.0"},"reference-count":12,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,1,26]]},"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:p>A young college-going male presented with worsening dyspnoea and palpitations for 6\u2009months. He was diagnosed with rheumatic heart disease. The patient\u2019s echocardiogram showed not only rheumatic affection of the mitral valve with restricted leaflet movements, but there was also a calcified hyperechogenic mass attached to the atrial aspect of the anterior mitral leaflet, which signified a probable calcified thrombus or an organised vegetation; and a heterogenous, low-attenuating mass attached to the interatrial septum characterised as an atrial myxoma. Considering the gravity of the situation, the patient underwent a successful removal of intracardiac masses with a bioprosthetic mitral valve replacement urgently. Although reported, the occurrence of atrial myxoma with rheumatic heart disease is a rare phenomenon. Left atrial thrombus and myxoma can mimic each other and pose a diagnostic challenge even in today\u2019s era of multimodality imaging.<\/jats:p>","DOI":"10.1136\/bcr-2024-263506","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T09:35:22Z","timestamp":1738575322000},"page":"e263506","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Triple trouble: rheumatic heart disease, infective endocarditis, atrial myxoma"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3298-6217","authenticated-orcid":false,"given":"Bhavik Sandip","family":"Shah","sequence":"first","affiliation":[{"name":"Cardiology, KEM Hospital and Seth G S Medical College, Mumbai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ishita C","family":"Lanjewar","sequence":"additional","affiliation":[{"name":"KEM Hospital and Seth G S Medical College, Mumbai, MH, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaurish","family":"Sawant","sequence":"additional","affiliation":[{"name":"Cardiovascular and Thoracic Surgery, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Balaji D","family":"Aironi","sequence":"additional","affiliation":[{"name":"Cardiovascular and Thoracic Surgery, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,2,3]]},"reference":[{"key":"2025082801115242000_18.2.e263506.1","first-page":"165","article-title":"Rheumatic Heart Disease","volume":"35","author":"Nulu","year":"2017","journal-title":"Cardiol Clin"},{"key":"2025082801115242000_18.2.e263506.2","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/S1525-2167(02)00170-1","article-title":"A patient with rheumatic mitral stenosis and an atrial myxoma","volume":"4","author":"Khania","year":"2003","journal-title":"Eur J Echocardiogr"},{"key":"2025082801115242000_18.2.e263506.3","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1016\/j.jicc.2015.07.004","article-title":"A case of biatrial mass mimicking myxoma with rheumatic mitral stenosis with regurgitation of moderate severity","volume":"5","author":"Khanna","year":"2015","journal-title":"J Indian Coll Cardiol"},{"key":"2025082801115242000_18.2.e263506.4","first-page":"46","article-title":"Co-existing left atrial thrombus and myxoma in mitral stenosis--a diagnostic challenge","volume":"40","author":"Sim","year":"1999","journal-title":"Singapore Med J"},{"key":"2025082801115242000_18.2.e263506.5","doi-asserted-by":"crossref","first-page":"25","DOI":"10.5430\/crim.v4n1p25","article-title":"A rare association of left atrial myxoma with rheumatic mitral stenosis","volume":"4","author":"Vaidya","year":"2016","journal-title":"CRIM"},{"key":"2025082801115242000_18.2.e263506.6","first-page":"S1","article-title":"Wandering large left atrial thrombus","volume":"2","author":"Hange","year":"2018","journal-title":"IHJ Cardiovasc Case Rep CVCR"},{"key":"2025082801115242000_18.2.e263506.7","unstructured":"National Centre For Disease Control . National treatment guidelines for antimicrobial use in infectious diseases. Available: https:\/\/ncdc.mohfw.gov.in\/wp-content\/uploads\/2024\/03\/16436207411618303414.pdf"},{"key":"2025082801115242000_18.2.e263506.8","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1016\/S0140-6736(11)61171-9","article-title":"Rheumatic heart disease","volume":"379","author":"Marijon","year":"2012","journal-title":"The Lancet"},{"key":"2025082801115242000_18.2.e263506.9","doi-asserted-by":"publisher","DOI":"10.4250\/jcu.2010.18.4.154"},{"key":"2025082801115242000_18.2.e263506.10","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/S0894-7317(14)80442-2","article-title":"Transesophageal Echocardiographic Evaluation of Left Atrial Mass Lesions","volume":"4","author":"Alam","year":"1991","journal-title":"J Am Soc Echocardiogr"},{"key":"2025082801115242000_18.2.e263506.11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199512143332407"},{"key":"2025082801115242000_18.2.e263506.12","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-120-3-199402010-00001"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-263506","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:11:58Z","timestamp":1756368718000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-263506"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":12,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2,3]]},"published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1136\/bcr-2024-263506"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-263506","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,2]]}}}