{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T15:03:46Z","timestamp":1779721426265,"version":"3.53.1"},"reference-count":45,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background and Clinical Significance: The crista terminalis (CT) is a physiological fibromuscular ridge in the right atrium. While benign, rare cases of CT hypertrophy present a diagnostic challenge, as it can mimic a pathological right atrial mass on cardiac imaging. The CT also presents arrhythmogenic potential and is known to be associated with right atrial tachyarrhythmias. Case Presentation: We present the case of a 58-year-old female that presented with rapid, irregular palpitations, accompanied by hypertension. Holter electrocardiography (ECG) confirmed self-limiting episodes of atrial tachycardia (max heart rate 170 bpm). Initial transthoracic echocardiography (TTE) identified an echogenic, non-mobile mass on the posterolateral right atrial wall. Transesophageal echocardiography (TEE) confirmed a 12 \u00d7 9 mm homogenous structure with a broad base of implantation and no intrinsic mobility, initially raising the suspicion of an atrial lipoma. Subsequent cardiac computed tomography angiography (CCTA) provided high-resolution tissue characterization, identifying the mass as a hypertrophied CT due to its precise anatomical orientation and its lack of contrast enhancement, also ruling out neoplastic and thrombotic aetiologies. Conclusions: CT hypertrophy is a key differential diagnosis for right atrial masses, particularly in females in their sixth decade. A multimodal imaging approach, transitioning from TTE to TEE and finally CCTA or Cardiac Magnetic Resonance Imaging (CMR), is advantageous in preventing unnecessary invasive interventions or anticoagulation.<\/jats:p>","DOI":"10.3390\/diagnostics16111615","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T14:10:22Z","timestamp":1779718222000},"page":"1615","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["When Palpitations Unmask Crista Terminalis Hypertrophy: A Case Report and Review of Current Literature"],"prefix":"10.3390","volume":"16","author":[{"given":"Antonia","family":"Racz","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Iuliu Ha\u0163ieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3964-6995","authenticated-orcid":false,"given":"Alexandra","family":"D\u0103d\u00e2rlat-Pop","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Iuliu Ha\u0163ieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania"},{"name":"Cardiology Department, Heart Institute Niculae St\u0103ncioiu, 19-21 Motilor Street, 400001 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adela","family":"\u0218erban","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Iuliu Ha\u0163ieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania"},{"name":"Cardiology Department, Heart Institute Niculae St\u0103ncioiu, 19-21 Motilor Street, 400001 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raluca","family":"Tomoaia","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Iuliu Ha\u0163ieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania"},{"name":"Cardiology Department, Rehabilitation Hospital, 400066 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7686-7378","authenticated-orcid":false,"given":"Alexandru","family":"Oprea","sequence":"additional","affiliation":[{"name":"Cardiology Department, Heart Institute Niculae St\u0103ncioiu, 19-21 Motilor Street, 400001 Cluj-Napoca, Romania"},{"name":"Cardiovascular Surgery Department, Heart Institute Niculae St\u0103ncioiu, 19-21 Motilor Street, 400001 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0570-0642","authenticated-orcid":false,"given":"Horia","family":"Rosianu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Iuliu Ha\u0163ieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania"},{"name":"Cardiology Department, Heart Institute Niculae St\u0103ncioiu, 19-21 Motilor Street, 400001 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"bcr2015211532","DOI":"10.1136\/bcr-2015-211532","article-title":"When Is a Mass Not a Mass? 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